新型单手保护会阴法在足月产妇自由体位顺产中的应用

Effect and prognosis of new single-handed perineum protection method in free posture delivery of full-term parturient

目的探讨新型单手保护会阴法在足月产妇自由体位顺产中的应用效果,为临床治疗提供依据。方法选取2018年8月至2019年8月在清远市清城区人民医院妇产科待产的足月产妇80例进行研究,采用随机数表法将其分为观察组和对照组各40例。对照组产妇采取传统双手保护会阴法分娩,观察组产妇采取新型单手保护会阴法分娩。比较两组产妇会阴裂伤、会阴疼痛、产程时间、产后出血量以及新生儿窒息发生情况。结果两组产妇会阴裂伤程度均集中在Ⅰ~Ⅱ度,观察组产妇会阴裂伤总发生率为12.50%,明显低于对照组的35.00%,差异有统计学意义(P<0.05);观察组产妇会阴疼痛分级情况主要集中在0~1级,对照组产妇会阴疼痛分级情况主要集中在2~3级,观察组产妇会阴疼痛分级情况明显优于对照组,差异有统计学意义(P<0.05);观察组产妇第一产程时间、第二产程时间、第三产程时间[(352.60±101.70) min、(67.80±19.50) min、(6.90±1.50) min]明显短于对照组[(435.74±101.20) min、(94.40±19.60) min、(8.20±1.60) min],差异均有统计学意义(P<0.05);观察组产妇产后2 h出血量为(190.65±42.37) m L,明显少于对照组的(246.41±43.10) mL,新生儿窒息率为5.00%,明显低于对照组的22.50%,差异均有统计学意义(P<0.05)。结论新型单手保护会阴法在足月产妇自由体位分娩中的应用效果显著,其不仅能有效改善产妇会阴裂伤程度,缓解会阴疼痛,缩短产程,降低产后出血量,还能减少新生儿窒息的发生,值得临床推广使用。

Objective To explore the effect of new single-handed perineal protection method in free posture delivery of full-term puerpera, and to provide basis for clinical treatment. Methods Eighty full-term pregnant women who were to be delivered in the Department of Obstetrics and Gynecology, Qingyuan Qingcheng People’s Hospital from August 2018 to August 2019 were selected for research. They were divided into observation group and control group by random number table method, with 40 patients in each group. The puerpera in the control group underwent delivery by traditional perineal protection with both hands, and the puerpera in the observation group were given single-handed perineum protection delivery. The incidence of perineum laceration, perineum pain, time of labor, postpartum hemorrhage, and neonatal asphyxia were compared between the two groups. Results The degree of perineal laceration in both groups was concentrated in degree ⅠtoⅡ. The total incidence of perineal laceration in the observation group was12.50%, which was significantly lower than 35.00% in the control group(P<0.05). The grading of perineal pain in the observation group was mainly concentrated in the grades 0 to 1, which were significantly better than the grades 2 to 3 in the control group(P<0.05). The first stage of labor, the second stage of labor, and the third stage of labor in the observation group were(352.60 ± 101.70) min,(67.80 ± 19.50) min,(6.90 ± 1.50) min, significantly shorter than(435.74 ±101.20) min,(94.40±19.60) min,(8.20±1.60) min in the control group(P<0.05). The postpartum hemorrhage in the observation group at 2 hours was(190.65±42.37) m L, which was significantly less than(246.41±43.10) mL in the control group, and the neonatal asphyxia rate in the observation group was 5.00%, which was significantly lower than 22.50% in the control group, with statistically significant differences(P<0.05). Conclusion The new single-handed perineum protection method has a significant effect on the free position delivery of term women, which can not only effectively improve the degree of perineum laceration, relieve perineal pain, shorten the labor process, reduce the amount of postpartum hemorrhage, and reduce the incidence of neonatal asphyxia, which is worthy of clinical promotion.