不同助产方式配合无保护会阴接生的临床分析

Clinical analysis of unprotected perineum deliver with different ways of midwifery

目的探讨不同助产方式配合无保护会阴接生的临床效果。方法选取成都市龙泉驿区第一人民医院于2011年10月至2014年8月经阴道分娩的1 857例初产妇,按照不同接生处理方法分为A、B、C、D组,A组398例为单纯无保护会阴接生,B组459例以导乐助娩配合无保护会阴接生,C组418例以双侧会阴阻滞麻醉配合无保护会阴接生,D组582例同时采用导乐助娩与双侧会阴阻滞麻醉配合无保护会阴接生,比较4组接生成功率、会阴完整率、疼痛情况等临床效果。结果 D组的无保护会阴接生成功率、会阴完整率、新生儿评分高于其他3组,产后出血、第二产程时间少于其他3组,产妇满意度、产妇情绪状态优于其他3组(均P<0.05)。结论导乐助娩与双侧会阴阻滞麻醉配合无保护会阴接生提高了产科接生质量,安全有效。

Objective To investigate the clinical effect of unprotected perineum deliver with different ways of midwifery.Methods 1 857 cases of primiparas in Longquanyi District First people＇s Hospital from Oct 2011 to Aug 2014 who underwent natural childbirth were selected and divided into group A,B,C,D according to different ways of midwifery. 398 cases in group A were unprotected perineum deliver,459 cases in group B were unprotected perineum deliver with doula midwifery,418 cases in group C were unprotected perineum deliver with bilateral perineum block anesthesia,582 cases in group D were unprotected perineum deliver with doula midwifery combined with bilateral perineum block anesthesia. The clinical effect such as delivery success rate,perineal integrity rate,pain situation,et al were compared. Results The delivery success rate,perineal integrity rate,apgar score of group D were higher than that of the other 3 groups,the postpartum hemorrhage and second birth course of group D were less than that of the other 3 groups,the maternal satisfaction and maternal emotional state of group D were superior to that of the other 3 groups（ all P〈0. 05）. Conclusion The unprotected perineum deliver with doula midwifery combined with bilateral perineum block anesthesia promotes the quality of obstetric deliveries which is safe and effective.