不同人工破膜方式在产科临床应用中的随机对照研究

Comparison of different methods for membrane rupture in clinical obstetrics

目的探讨分析夹针破膜、组织钳破膜及消毒棉棒破膜在分娩时人工破膜术中的临床应用价值。方法选择阴道分娩产妇283例,按随机数字表法分为3组,A组采用夹针破膜,B组采用组织钳破膜,C组采用消毒棉棒破膜,并比较3组破膜方式的成功率、破膜时患者疼痛评分、医务人员职业暴露率、剖宫产率及胎儿损伤情况。结果3组破膜成功率、剖宫产率、胎儿损伤率各组间比较差异均无统计学意义(均P>0.05)。3组患者职业暴露率,A组和B组职业暴露人数所占比例明显高于C组,差异有统计学意义(P<0.05)。3组患者疼痛评分,差异有统计学意义(P<0.05),A组和B组疼痛评分明显高于C组患者,差异有统计学意义(P<0.05);A组和B组疼痛评分差异无统计学意义(P>0.05)。结论棉棒破膜与夹针破膜及组织钳破膜在破膜成功率上无统计学差异,但其破膜时患者疼痛评分及医务人员职业暴露率低于夹针破膜及组织钳破膜,具有一定的临床应用价值。

Objective To compare different methods of artificial membrane rupturing in childbirth.Methods A total of 283 vaginal delivery women were randomly divided into 3 groups:needle rupture was applied in group A,tissue forceps was applied in group B and sterilized cotton swab was applied in group C to rupture the membrane.The successful rate of rupture,pain score of patients,occupational exposure rate of medical staff,uterine-incision delivery rate and fetal injury rate were compared among 3 groups.Results There were no significant differences in the successful rate rupture,uterine-incision delivery and fetal injury rate among the three groups(P>0.05).The occupational exposure rate of group A and group B was significantly higher than that of the group C(P<0.05).The pain scores of group A and group B were significantly higher than those of group C(P<0.05);while there was no significance between group A and group B(P>0.05).Conclusion The success rate of membrane rupture is the same with three different methods;while the pain score of patients and occupational exposure of medical staffs in membrane rupturing with sterilized cotton are lower than those with needle or tissue forceps.