中药产妇垫用于会阴侧切伤口的临床观察

Clinical effect of maternal pat with Chinese medicine in patients with episiotomy wound care

目的观察中药产妇垫用于会阴侧切伤口护理的临床效果。方法将北京同仁医院产科2013年6月至2014年6月孕足月、阴道分娩行会阴侧切术的1100例产妇，随机分为试验组和对照组各550例，试验组常规护理配合使用中药产妇垫护理会阴伤口，对照组常规护理配合使用普通产妇垫，比较两组产妇会阴肿胀、切口疼痛及愈合情况。结果试验组会阴切口轻、中度肿胀率产后24h分别为35．5％（195／550）、6．0％（33／550），48h分别为13．4％（74／550）、1．6％（9／550）；对照组24h分别为51．5％（283／550）、24．5％（135／550），48h分别为34．2％（188／550）、2．7％（15／550），对照组会阴切口肿胀率明显高于试验组，两组比较差异有统计学意义（Z值分别为12．555、8．144，P均〈0．01）。试验组会阴切口中、重度疼痛率产后24h分别为12．5％（69／550）、2．9％（16／550），产后48h分别为8．4％（46／550）、1．3％（7／550）；对照组24h分别为37．3％（205／550）、7．5％（41／550），48h分别为20．6％（113／550）、3．5％（19／550），对照组会阴切口疼痛率明显高于试验组，两组比较差异有统计学意义（Z值分别为10．429、11．886，P均〈0．01）。会阴伤口甲级愈合率试验组（92．36％）高于对照组（80．73％），伤口感染率试验组（1．82％）明显低于对照组（3．82％）；试验组使用舒适满意度（90．18％）明显高于对照组（73．09％），两组比较差异均有统计学意义（Z值分别为-5．614、-7．345，P均〈0．01）。结论中药产妇垫护理会阴侧切伤口可有效减轻伤口肿胀、疼痛，促进伤口愈合，使用方便舒适，值得临床推广。

Objective To investigate the clinical effect of maternal pat with Chinese medicine in episiotomy wound care. Methods One thousand one hundred cases of maternal with full-term, vaginal delivery, episiotomy in the Beijing Tongren Hospital Affiliated to Capital Medical University from Jun. 2013 to Jan. 2014 were randomly divided into test group and control group. Patients in test group were given routine nursing care combined with Chinese medicine maternal pat to nurse perineal wound, while in the control group were given routine nursing combined with common maternal pat. The data of perineal wound swelling, pain and healing were recorded and compared in two groups. Results The incidences of mild, moderated swelling within 24 h,48 h in test group were 35.5% （195/550） and 6. 0% （33/550）, 13.4% （74/550） and 1.6% （9/550）, significantly lower than that of the control group （24 h：51.5% （283/550） ,24. 5% （135/550） ;48 h：34. 2% （ 188/550）, 2. 7% （15/550） ;Z = 12. 555,8. 144;P 〈 O. 01 ）. The incidences of moderate, severe pain within 24 h,48 h in test group were 12. 5% （69/550） and 2. 9% （16/550） ,8.4% （46/550） and 1.3% （7/550） ,significantly lower than that of the control group （24 h：37.3% （205/550） ,7.5% （41/550） ;48 h：20. 6% （113/550） ,3.5% （19/550） ;Z = 10. 429,11. 886; P 〈 0. 01 ）. The wound healing rate in test group was 92. 36%, significantly higher than that of control group （ 80. 73.%, P 〈 0. 01 ）. The wound infection rate in test group was 1.82%, significant lower than that of control group（3.82% ,P 〈 0. 01 ）. The incidence of comfort and satisfaction in test group was 90. 18 %, significantly higher than that of control group （73. 09% ;Z = -5. 614, -7. 345;P 〈 0. 05）. Conclusion Nursing lateral episiotomy wound using Chinese medicine maternal pat can reduce the swelling, pain and promote wound healing with convenient and comfortable. Therefore, it is worth of the clinical popularization and application.