会阴侧切改良技术防止新生儿分娩性肩损伤临床效果观察

Clinical study of the effectiveness of the improved episiotomy incision in reducing occurence of shoulder dystocia

目的:观察会阴侧切改良技术在经阴分娩中防止新生儿分娩性肩损伤的效果.方法:选择入我院经阴分娩产妇,963例为观察组,1140例为对照组Ⅰ,400例为对照组Ⅱ.观察组会阴侧切术改良为15°～40°的小角度,2～4cm的短切口,对照组Ⅰ采用传统会阴侧切术,对照组Ⅱ不行会阴切开术.三组观察指标同为:娩肩困难、CF、臂丛神经损伤等发生情况.统计学处理应用SPSS10.0统计软件处理.计数资料χ2检验.结果:新生儿出现娩肩困难,观察组明显低于对照组,P＜0.01,观察组、对照组Ⅱ为0,对照组Ⅰ发生25例,P＜0.01,有显著性差异.结论改良技术可有效的防止经阴分娩中新生儿肩性损伤,值得临床推广.

Objectives： To investigate the effectiveness of the improved episiotomy incision in reducing the occurence of shoulder dystocia. Methods ：Choose transvaginal delivery （natal） parturientin our hospital, the improved group in cluded nine hundred and sixty-three pregant women, the control group Ⅰ included one thousand one hundred and forty cases, the control group Ⅱ included four hundred cases. Improved lateral perinevtomy was performed in 15～40 degree angle and the length of incision was about 2 - 4 antimeters, the confrol group Ⅰ choose, lateral perinevtomy, the control group H didn＇t.Shoulder dystocia clavicular fracture, brachial plexus injury were observed, spss 10.0 was applied to analyse data. Results：Occurrence of shoulder dystocia was obviouly less in the improved group than that in the control group Ⅰ（ P〈0. 01 ）. No one occurred CF in the improved group and the control group Ⅱ ,and there were 25 cases in the control group（P 〈0. 01 ）Con clusions ：The improved epsitomy was effective in reduing the occurence of shoulder dystocia,it was worthy of being popularized.