改良式会阴侧切术298例的临床效果观察

The clinical application and effect observation of improved lateral epi-siotomy in 298 cases

目的探讨初产妇应用改良式会阴侧切术进行自然分娩的临床效果。方法选取我院产科行阴道分娩的初产妇298例,随机分为观察组和对照组各149例,观察组患者行改良式会阴侧切术,对照组患者行传统会阴侧切术,比较两组患者会阴切口愈合情况、术后疼痛分级、撕裂伤发生情况、术后住院时间。结果观察组患者Ⅱ级愈合占2.01%,对照组患者Ⅱ级愈合及伤口感染占12.75%,观察组患者伤口愈合情况明显优于对照组（P〈0.05）;观察组患者术后疼痛明显轻于对照组（P〈0.05）。观察组撕裂伤发生率为20.80%,对照组为47.65%,观察组患者撕裂伤发生率明显低于对照组（P〈0.05）。观察组患者术后平均住院时间为（3.24±0.21）d,对照组为（4.82±0.19）d,观察组患者术后平均住院时间明显短于对照组（P〈0.05）。结论 25°~30°改良式会阴侧切术可减轻产妇产后疼痛,降低撕裂伤发生率,改善伤口愈合情况,缩短术后住院时间。

Objective To investigate the clinical effect of improved lateral episiotomy on natural childbirth for primi- para. Methods Selected 298 cases of primipara that was to for vaginal delivery in the obstetrics of our hospital and di- vided them into observation group and control group with 149 cases in each group randomly. The observation group accepted modified lateral episiotomy for treatment and the control group accepted the conventional lateral episiotomy. The perineum incision healing happens, grading of postoperative pain, laceration of postoperative, time of postopera- tive hospital stay to investigate the clinical effect of modified lateral episiotomy were compared. Results There was 2.01% of patients occurred Ⅱ healing in the observation group and 12.75% of patients occurred Ⅱ healing and wound infection in the control group. The observation group was significantly better than the control group on wound healing （P〈0.05）. The observation group was significantly lighter than the control group on postoperative pain （P〈0.05）. The rate of laceration incidence in observation group and control group were 20.80% and 47.65%. The observation group was significantly lower than the control group on the rate of laceration （P〈0.05）. The mean time of postoperative hospi- tal stay were （3.24±0.21） d and （4.82±0.19） d. The observation group was shorter than the control group on mean time of postoperative hospital stay significantly, and there was significant difference between two groups （P〈0.05）. Conclu- sion The improved lateral episiotomy under 25°-30° can reduce maternal postpartum pain, reduce the incidence of laceration, improve wound healing, shorten the days of hospitalization after operation.