阴道分娩会阴Ⅲ～Ⅳ度裂伤原因分析及缝合修复对阴道、肛门直肠功能的影响

Analysis of Causes on Ⅲ～Ⅳ Degree of Perineum Laceration due to Vaginal Delivery. and Influence of Sutured Repair to Function of Vagina and Anorectum

为提高阴道分娩会阴Ⅲ～Ⅳ度裂伤的诊治水平．及探讨缝合修复对阴道、肛门直肠功能的影响．本研究对足月妊娠阴道分娩的15例会阴Ⅲ～Ⅳ度裂伤的原因及诊治过程进行分析。结果发现，本组巨大儿（体重≥4000g）2例，急产2例，胎儿即将娩出时产妇不合作1例，会阴瘢痕3例，会阴体较短、发育薄弱3例，会阴体过长伴肥厚1例，胎位不正以持续性枕后位娩出2例，外阴未完全扩张助产人员急于让胎儿娩出在宫底部加压1例。且经产妇多于初产妇。给予严格消毒、止血、缝合后阴道及肛门直肠功能均恢复良好。结果表明，减少产生会阴裂伤的关键在于预防，一旦发生应及时处理，对阴道及肛门直肠功能无明显影响。

The aim of this study was to enhance the level of diagnosis ＆ treatment for Ⅲ～Ⅳ degree of perineum laceration due to vaginal delivery,and to explore the influence of sutured repair to function of vagina and anorectum. Author analysed the cause and diagnosis ＆ treatment course of 15 cases with Ⅲ～Ⅳ degree of perineum laceration who had all been uterogestation and vaginal delivery. Analysed results showed that fetal macrosomia（body-weight ≥4000g） was in 2 cases, emergency delivery in 2 cases,one parturient refused cooperation when fetal is about to be deliveried,perineum scar in 3 cases, perineal body did being shorter and of weaker ＆ thin development in 3 cases,perineal body did being too longer and hypertrophic in 1 case,continuous posterior occipital location to delivery owing to non-correct position in 2 cases,midwife being anxious to press for delivery fetus at uterus floor when vulva did not extended incompletely in 1 case;among the 15 cases multipara were more than primipara;through strictly disinfecting,hemostasis and suture,function of vagina and anorectum were all reeoveried better. Results show that the key to reduce perineum laceration is prevention,at once it occures,it should he to be timely managed.