无保护会阴助娩法对初产妇分娩过程中会阴侧切率的影响

Effect of unprotected perineal delivery on perineal side cut rate in primipara during childbirth

目的探讨无保护会阴助娩过程中对会阴侧切率的影响。方法选取2018年3-6月浙江萧山医院产科自然分娩的初产妇210例为研究对象,依据助娩方式,将其分为观察组(108例)和对照组(102例)。对照组采用传统保护会阴的助娩方法,观察组采用无保护会阴的助娩方法。比较两组初产妇分娩后会阴的情况,包括会阴侧切率、会阴完整率、会阴裂伤率。结果观察组行会阴侧切者36例,占33.33%,对照组行会阴侧切者48例,占47.06%,两组差异有统计学意义(χ2=4.118,P=0.042)。观察组会阴完整者25例,占23.15%,对照组会阴完整者9例,占8.82%,两组差异有统计学意义(χ2=7.933,P=0.005)。观察组会阴Ⅰ度裂伤39例,占36.11%,Ⅱ度裂伤6例,占5.56%,对照组会阴Ⅰ度裂伤35例,占34.31%,Ⅱ度裂伤15例,占25.49%,两组差异均有统计学意义(χ2=0.074、4.880,P=0.785、0.027)。结论采用无保护会阴助娩法可降低初产妇的会阴侧切率,减轻会阴损伤程度,值得临床推广。

Objective To investigate the effect of unprotected perineal delivery on perineal side cut rate in primipara during childbirth. Methods From March 2018 to June 2018, 210 primiparas from the Obstetrics and Gynecology Department of Zhejiang Xiaoshan Hospital were selected in the study.They were divided into observation group (108 cases) and control group (102 cases) according to the delivery method.The control group used protected perineal delivery method, and the observation group used unprotected perineal delivery method.The perineal side cut rate, the perineal integrity rate, the perineal laceration rate were compared between the two groups. Results 36 cases were treated with perineal side cut in the observation group, accounting for 33.33%, and 48 cases with perineal side cut in the control group, accounting for 47.06%, there was statistically significant difference between the two groups(χ2=4.118, P=0.042).25 patients had complete perineum in the observation group, accounting for 23.15%, and 9 patients in the control group had complete perineum, accounting for 8.82%, there was statistically significant difference between the two groups(χ2=7.933, P=0.005). The observation group had 39 cases of degree Ⅰ perineal laceration (36.11%) and 6 cases of degree Ⅱ perineal laceration (5.56%). The control group had 35 cases of degree Ⅰ perineal laceration (34.31%) and 15 cases of degree Ⅱ perineal laceration (25.49%), there was statistically significant difference between the two groups(χ2=0.074, 4.880, P=0.785, 0.027). Conclusion Unprotected perineal delivery method can reduce the perineal cut rate of primipara and the occurrence of perineal laceration, which is worthy of clinical promotion.