拇指法会阴无保护接生在自然分娩中的应用及分析

Application and analysis of unprotected perineum delivery by means of thumb method in spontaneous delivery

目的探讨拇指法会阴无保护接生在自然分娩中的应用效果以及应用价值。方法选取2016年1月至2017年1月收治的400例孕妇,随机分为观察组和对照组,每组200例。观察组孕妇在产程中采用拇指法会阴无保护接生,对照组采用传统会阴保护接生。分别比较2组产妇的一般情况(第二产程时间、产后出血量)、母婴结局(会阴裂伤率、阴道助产率、新生儿窒息率)、产后并发症(会阴伤口感染率、尿潴留发生率、盆底肌力异常发生率)以及产妇满意程度(会阴疼痛VAS评分、产妇满意度评分)。结果观察组第二产程时间、产后出血量、会阴疼痛VAS评分均显著低于对照组,差异有统计学意义(均P<0.05)。观察组会阴裂伤率、会阴伤口感染率、尿潴留发生率、盆底肌力异常发生率、新生儿窒息率均显著低于对照组,2组比较差异有统计学意义(P<0.05),观察组满意度评分显著高于对照组,2组比较差异有统计学意义(P<0.05),观察组和对照组在阴道助产率上差异无统计意义(P>0.05)。结论采用拇指法会阴无保护接生可有效缩短产妇第二产程时间,减少产后并发症的出现,改善母婴结局,且不增加阴道助产概率,有较高的患者满意度,具有临床推广和利用价值。

Objective To explore the effects and application value of unprotected perineum delivery by means of thumb method in spontaneous delivery.Methods A total of 400 pregnant women admitted who were admitted into our hospital from January 2016 to January 2017 were randomly divided into observation group(n=200) and control group(n=200). The pregnant women in observation group were treated with unprotected perineum delivery by means of thumb method during the labor process,however,the pregnant women in control group were treated by traditional perineal protection delivery.The general conditions including the duration of the second stage of labor,postpartum hemorrhage,and maternal and infantile outcomes including perineal laceration rate,vaginal assist rate,neonatal asphyxia rate,and postpartum complications including perineal wound infection rate,urinary retention incidence,pelvic floor muscle abnormality rate as well as maternal satisfaction degree according to perineal pain VAS score and maternal satisfaction score Were observed and compared between the two groups. Results The duration of the second stage of labor,postpartum hemorrhage and perineal pain VAS scores in observation group were significantly lower than those in control group(P<0.05).The incidence rates of perineal laceration,perineal wound infection,urinary retention,pelvic floor muscle abnormality and neonatal asphyxia in observation group were significantly lower than those in control group(P<0.05).Moreover the satisfaction degree scores in observation group were significantly higher than those in control group(P<0.05).However there was no significant difference in vaginal delivery rate between the two groups(P>0.05).Conclusion The application of thumb method for unprotected delivery of perineum can effectively shorten the duration of the second stage of labor,reduce the incidence of postpartum complications,improve maternal and infantile outcomes,which does not increase the probability of vaginal delivery,with higher patient’s satisfaction degree,therefor, which has clinical application and promotion value.