无保护会阴分娩产妇会阴裂伤的危险因素分析

The risk factors of maternal perineal laceration among lying-in women using unprotected perineal delivery technique

目的 :调查应用无保护会阴分娩技术的产妇会阴裂伤情况,并分析其危险因素,为对症护理及早期预防提供依据。方法 :回顾性分析2015年11月至2016年4月我院分娩室应用无保护会阴分娩技术助产的563例产妇会阴裂伤的发生率及严重程度,并采用Logistic回归分析研究其危险因素。结果 :无保护会阴分娩产妇会阴裂伤的发生率为63.6%,其中Ⅰ度裂伤占93.9%,Ⅱ度裂伤占6.1%;Logistic回归分析结果显示,初产妇、胎儿体质量3 500~3 999 g、助产士工作年限<5年、产前会阴水肿是无保护会阴分娩产妇发生会阴裂伤的独立危险因素。结论 :应用无保护会阴分娩技术的产妇同样存在会阴裂伤的情况,但损伤程度较轻,多以Ⅰ度裂伤为主;应针对危险因素进行全面的产前评估并采取相应预防措施,减少无保护会阴分娩产妇会阴裂伤的发生。

Objective： To explore the current status and risk factors of maternal perineal laceration among lying-in women using unprotected perineal delivery technique, and to provide guidance for early prevention and nursing care of the perineal laceration. Methods： Retrospective analysis of the incidence, severity and risk factors of perineal laceration among 563 lying-in women using unprotected perineal delivery technique from November 2015 to April 2016 in our hospital. Results： The incidence of perineal laceration among lying-in women using unprotected perineal delivery technique was 63.9%. The major injury type of perineal laceration is I degree laceration （93.9%） and II degree laceration （6.1%）. Logistic regression analysis showed that the independent risk factors ofperineal laceration were primipara, fetal weight 3500-3999 g, midvives working years less than 5 years and prenatal perineum edema （P〈0.05）. Conclusion： Lying-in women using unprotected perineal delivery technique could develop perineal laceration, but the major injury type is I degree laceration. We should conduct comprehensive assessment according to the risk factors before delivery and take corresponding preventive measures to reduce the incidence ofoerineal laceration.