无保护会阴联合拆台助产在促进自然分娩中的应用分析

Unprotected perineal midwifery in promoting the application of sabotage in natural childbirth

目的探讨无保护会阴联合拆台助产在促进自然分娩中的应用效果。方法选取2016年7月至2017年12月期间本院收治的180例产妇进行研究。将产妇随机分为无创助产组、改良组和传统组,每组60例,分别采用无保护会阴联合拆台助产、会阴保护联合拆台站立助产和传统的侧面助产。比较3组的会阴结局、新生儿结局和产后并发症情况。结果无创助产组和改良组的会阴Ⅰ度裂伤率分别为45.00%和41.67%,显著高于传统组(23.33%),无创助产组的会阴侧切率(20.00%)显著低于改良组(58.33%)和传统组(61.67%),差异均有统计学意义(P<0.05)。3组的新生儿体重、Apgar评分、巨大儿及肩难产发生率相比,差异均不具有统计学意义(P>0.05)。无创助产组的严重疼痛发生率和产褥感染发生率显著低于改良组和传统组,差异均有统计学意义(P<0.05)。结论无保护会阴联合拆台助产降低了会阴侧切率和裂伤程度,新生儿结局良好,对产后恢复无不良影响,有助于促进自然分娩。

Objective To investigate the protection of perineal midwifery in defeating application effect in promoting natural delivery.Methods From July 2016 to December 2017, 180 cases of maternity in our department of Obstetrics and gynecology were studied. The patients were randomly divided into noninvasive midwifery group and improved group and traditional group, 60 cases in each group, respectively with unprotected perineal midwifery, perineal joint protection against sabotage of midwifery and traditional midwifery side stand.The perineum outcome, neonatal out-come and postpartum complications were compared between the three groups. Results The rate of perineal first degree laceration in the midwifery group and the improved group were 45.00% and 41.67%,which were significantly higher than that in the traditional group（23.33%）（ P〈0.05）, and the lateral episiotomy rate in the noninvasive midwifery group（20.00%） was significantly lower than that in the improved group（58.33%）and the traditional group（61.67%）（P〈0.05）.The difference between the three groups was not statistically significant（ P〈0.05）, compared with the birth weight of the newborn, the Apgar score, the incidence of the huge and shoulder dystocia. The incidence of severe pain and puerperal infection in the non invasive mid-wifery group was significantly lower than that in the improved group and the traditional group, and the difference was statistically significant（ P〈0.05）.Conclusion Unprotected perineal tear midwifery reduce episiotomy rate and laceration, neonatal outcome is good, no adverse effects on postpartum recovery, help to promote natural childbirth.