会阴不侧切无保护与会阴侧切的分娩效果比较

Comparative studies of the effect of lateral episiotomy and unprotected non-lateral episiotomy in labor

目的比较会阴不侧切无保护与会阴侧切两种顺产分娩方法的效果。方法选取2018年1至5月在温州市中心医院分娩的初产妇60例,随机分为干预组和对照组各30例,对照组分娩时给予常规会阴侧切,干预组进行会阴不侧切无保护顺产,评估两组产后出血率、产后疼痛指数、产后舒适度、新生儿窒息和阴道软组织裂伤情况。结果干预组会阴完整比例高于对照组,而Ⅱ度会阴撕裂比例低于对照组,差异均有统计学意义(χ^2值分别为10.000、4.320,均P<0.05);干预组产后出血量低于对照组,差异有统计学意义(t=5.593,P<0.05);干预组和对照组分别有2例(6.67%)和8例(26.67%)发生新生儿窒息,差异有统计学意义(χ^2=4.320,P=0.038);干预组痛苦度评分低于对照组,而舒适度评分高于对照组,差异均有统计学意义(t值分别为6.943、9.031,均P<0.05)。结论初产妇实行会阴不侧切无保护的顺产方式,能够降低会阴撕裂损伤,减少产后出血量,提高孕妇及其家属的接受与满意程度。

Objective To evaluate the effects of spontaneous delivery with perineal lateral incision and unprotected non-lateral episiotomy.Methods From January 2018 to May 2018,60 primiparas who delivered in Wenzhou Central Hospital were studied while they were randomly divided into the intervention group and the control group(n=30,respectively).The control group was given routine lateral perineal incision.The intervention group was given unprotected non-lateral episiotomy.Then,the rate of cases with postpartum hemorrhage,postpartum pain index,postpartum comfort,neonatal asphyxia and vaginal soft tissue fissure were evaluated.Results The proportion of the cases with complete perineum in the intervention group was higher than that of the control group,while the proportion of the cases with degree Ⅱ perineum tear was lower than that of the control group.There was a significant difference between the two groups(χ^2=10.000,4.320,P<0.05).The amount of postpartum hemorrhage in the intervention group was lower than that of the control group,and there was a significant difference between the two groups(t=5.593,P<0.05).There were 2 cases(6.67%) and 8 cases(26.67%) of neonatal asphyxia in the intervention group and the control group,respectively.Significant differences were found out between two groups(χ^2=4.320,P=0.038).The pain score of the intervention group was lower than that of the control group,while the comfort score in the intervention group was higher than that of the control group.There were significant differences between the two groups(t=6.943,9.031,P<0.05 for both).Conclusions The unprotected non-lateral episiotomy for primiparas can reduce perineal tear injury,reduce postpartum hemorrhage and improve the acceptance,satisfaction of pregnant women and their families.