无保护会阴助产技术促进自然分娩的效果观察

Effects observation of unprotected perineum midwifery to promote natural childbirth

目的：探讨无保护会阴助产技术促进自然分娩的效果。方法选择190例阴道分娩的初产妇，按照随机数字表法分为观察组和对照组各95名。观察组产妇采用会阴无保护助产技术，对照组产妇采用常规助产技术。比较两组产妇会阴切开情况、会阴裂伤程度、新生儿窒息、产后会阴水肿及排尿困难情况。结果观察组产妇的会阴侧切率为10．5％，对照组为27．3％，差异有统计学意义（χ2＝8．773，P＜0．05）；两组产妇均未出现会阴Ⅲ度裂伤，观察组产妇的会阴完整率和会阴Ⅰ度裂伤率分别为9．4％和61．0％，对照组分别为4．2％和31．5％，观察组产妇的会阴裂伤程度明显低于对照组，差异有统计学意义（χ2＝14．782，P＜0．05）。观察组产妇会阴水肿发生率7．3％，对照组为21．0％，差异有统计学意义（χ2＝7．296，P＜0．05）。观察组产妇排尿困难发生率为2．1％，对照组为9．4％，差异有统计学意义（χ2＝4．728，P＜0．05）。观察组新生儿体质量为（3462．4±412．3）g，对照组为（3416．2±323．4）g，差异无统计学意义（t＝0．364，P＞0．05）。观察组发生新生儿窒息1例，对照组发生新生儿窒息2例，差异无统计学意义（χ2＝0．339，P＞0．05）。结论会阴无保护助产技术可降低会阴侧切率，减轻会阴损伤，减少产后会阴水肿及排尿困难，提高产妇舒适感，促进自然分娩。

Objective To discuss the effects of unprotected perineum midwifery to promote natural childbirth.Methods Totals of 190 cases of vaginal delivery primiparas in our hospital were randomly divided into the observation group and the control group , each with 95 cases.The observation group was adopted the unprotected perineum midwifery , while the control group was adopted the conventional method .The episiotomy, degree of perineal laceration , newborn asphyxia , postnatal perineal edema and dysuria of the two groups were compared.Results The rate of the episiotomy was 10.5% in the observation group and 27.3% in the control group.The difference was statistically significant （χ2 =8.773, P〈0.05）.There was no degree Ⅲof perineal laceration happened in both groups .The perineum integrity rate and degree Ⅰ of perineal laceration of the observation group were 9.4% and 61.0%.Those rates of the control group were 4.2% and 31.5%.The difference of the degree of perineal laceration was statistically significant （χ2 =14.782,P〈0.05）.The rate of postnatal perineal edema was 7.3% in the observation group and 21.0% in the control group.There was a significant difference between the two groups （χ2 =7.296,P〈0.05）.The rate of dysuria was 2.1% in the observation group and 9.4% in the control group.There was a significant difference between groups （χ2 =4.728,P〈0.05）.The weight of the newborn was （3 462.4 ±412.3）g in the observation group and （3 416.2 ± 323.4） g in the control group, respectively.There was a significant difference between the two groups （ t =0.364, P〉0.05）.One case in the observation group and two cases in the control group occurred newborn asphyxia.There was a significant difference between groups （χ2 =0.339, P 〉0.05）.Conclusions The unprotected perineum midwifery can reduce the rates of episiotomy , alleviate perineal injury , reduce the postnatal perineal edema and dysuria , and increase the puerpera ’ s comforts during the delivery .