165例产妇足月妊娠阴道分娩会阴裂伤临床分析

Clinical Analysis of Vaginal Delivery and Laceration of Perineum in 165 Full-term Pregnant Women

目的分析产妇足月妊娠阴道分娩会阴裂伤情况。方法将2016年1—3月165例足月妊娠阴道分娩产妇作为研究对象,根据会阴的裂伤情况和程度,将其分为I度和II度裂伤,其中I度裂伤134例,II度裂伤31例(其中包括2例实施会阴侧裂的产妇)。对两组的会阴裂伤的产程时间、术中出血、新生儿出生体质量、会阴弹性等进行分析和统计。结果 I度裂伤的足月妊娠阴道分娩产妇会阴弹性均比较好;II度裂伤的足月妊娠阴道分娩产妇,会阴均比较厚且弹性均比较差;产时出血量平均在(200±40)ml,新生儿体质量平均(3 032.34±21.13)g。第二产程时间(48.34±2.13)min。可见,II度裂伤的产妇会阴弹性、第二产程时间和I度裂伤产妇差异有统计学意义,P<0.05。而新生儿体质量、产时出血和分娩次数对比,差异无统计学意义,P>0.05。结论产妇足月妊娠阴道分娩会阴裂伤情况和产妇会阴弹性密切相关,可影响第二产程时间,因此对于会阴弹性较差的产妇需加强产程监测和防护,以有效降低会阴裂伤发生率。

Objective To analyze the situation of vaginal delivery and laceration of perineum during full-term pregnancy.Methods From January to March 2016,165 pregnant women with vaginal delivery were studied,according to the extent and laceration of perineum,which were divided into I degree and II degree laceration.Among them,I degree laceration occurred in 134 cases,II degree laceration in 31 cases（included 2 cases of episiotomy）.Delivery time of perineal laceration in two groups,intraoperative bleeding,neonatal birth weight,perineal elasticity was analyzed and statistically analyzed.Results Vaginal delivery for full-term pregnant women with I degree laceration was better for perineal elasticity;Vaginal delivery of full-term pregnant women with II degree laceration,perineum was thicker and the elasticity was poor;average amount of intrapartum bleeding was（200±40） ml,neonatal body mass average（3 032.34±21.13） g,second stage of labor time（48.34±2.13） min.So,perineum elasticity of II degree laceration,time of the second stage of labor between I degree laceration of maternal,there was difference,P〈0.05.Neonatal body mass,intrapartum bleeding and delivery times were compared,the difference was not statistically significant,P〈0.05.Conclusion A full-term pregnancy vaginal delivery of maternal perineal laceration and maternalperineal elastic are closely related,can affect the time of the second stage of labor,so the poor maternal perineal elastic to strengthen the production process monitoring and protection,to reduce the incidence of perineal laceration.