阴道分娩产妇会阴裂伤相关因素分析

The analysis of related factors in perineal tear after vaginal delivery

目的 探讨经阴道分娩产妇会阴裂伤的有关因素.方法 回顾分析我院1 322例经阴道自然分娩产妇会阴裂伤情况,并对产次、产程、产妇年龄、胎儿体重、使用宫缩剂、胎方位、接生者工作年限等因素进行分析.结果 初产妇Ⅱ度会阴裂伤发生率高于经产妇（P＜0.05）;随着胎儿体重的增加会阴裂伤发生率明显增加（P＜0.005）;接生者工作年限＜5年,其接生的产妇会阴裂伤发生率明显升高（P＜0.005）;急产不会增加会阴裂伤的发生率,但在不同裂伤程度的比例上有明显差别（P＜0.05）;产妇年龄的增加和使用宫缩剂并不增加会阴裂伤的发生率（P＞0.05）.结论 初产妇、胎儿体重增加、接生者工作经验不足是经阴道分娩会阴裂伤的主要因素.只要加强学习,提高自身技术水平,产前做好准备,产时仔细观察,及时发现各种异常情况,严格掌握手术助产的适应证,选择合适的分娩方式,可以减少会阴裂伤的发生.

Objective To explore the relevant factors of maternal perineal tear after vaginal delivery. Methods A retrospective analysis of 1 322 cases of maternal perineal tear after a natural vaginal delivery in our hospital was done, and production times, the birth process, maternal age, newborn birth weight, the use of contractions reagent, fetal position, birth attendants work experience and other factors were analyzed. Results Second degree perineal tear in primipara was higher than that of second or more vaginal deliveries （ P 〈 0. 05 ）;With the increase in newborn birth weight , the incidence of perineal tear was increased significantly （ P 〈 0. 005 ）; if birth attendants work experience was less than 5 years, the incidence of maternal perineal tear of vaginal delivery was significantly higher （ P 〈 0. 005 ）; urgent production did not increase the incidence of perineal tear, but there was significant difference in the proportion in different degrees of tear （P〈0.05 ）; maternal age and the use of contractions reagent did not increase the incidence of perineal tear （P 〉 0. 05 ） . Conclusions Primipara, newborn birth weight, the lack of work experience of birth attendants are the main factors of perineal tear after vaginal delivery. As long as enhancing learning, improving their technical level, prenatal preparation, observing carefully during porduction, detecting unusual circumstances in time, mastering the surgical indications for midwifery strictly, selecting the appropriate mode of delivery could reduce the incidence of perineal tear.