会阴无保护结合无痛分娩对初产妇分娩过程及产后盆底功能的影响

Effects of Unprotected Perineum Combined with Painless Delivery on Primipara’s Delivery Process and Postpartum Pelvic Floor Function

目的:探讨会阴无保护联合无痛分娩对初产妇分娩过程及产后盆底功能影响。方法:选取2015年1月-2018年12月本院收治的初产妇50例。按照随机数字表法将其分为对照组(采取会阴保护)和观察组(采用会阴无保护结合无痛分娩技术),各25例。比较两组产后一般情况、盆底功能、产妇及新生儿的并发症发生情况。结果:观察组第二产程时间、产后2 h出血量、住院时间、VAS评分均少于对照组,差异均有统计学意义(P<0.05);两组新生儿Apgar评分比较,差异无统计学意义(P>0.05)。观察组POP-QⅠ度占92.00%,高于对照组的64.00%(P<0.05);观察组Ⅰ、Ⅱ类肌纤维肌力显著高于对照组,差异均有统计学意义(P<0.05)。两组新生儿窒息发生率比较,差异无统计学意义(P>0.05);观察组伤口延期愈合、产褥感染、产后尿潴留、产后疼痛发生率均低于对照组,差异均有统计学意义(P<0.05)。结论:会阴无保护联合无痛分娩技术能够有效减轻产妇疼痛感,减少产后出血,缩短住院时间,能够有效维护盆底肌功能,降低并发症发生率。

Objective:To explore the effect of unprotected perineum combined with painless delivery on the delivery process and pelvic floor function of primipara.Method:From January 2015 to December 2018,50 primipara admitted to our hospital were selected.According to the method of random number table,they were divided into control group (perineum protection) and observation group (unprotected perineum combined with painless delivery),25 cases in each group.The general condition of postpartum,pelvic floor function,complications of parturient and newborn were compared between the two groups.Result:The second stage of labor,2 hours postpartum hemorrhage,hospitalization time and VAS score in the observation group were all lower than those in the control group,the differences were statistically significant (P<0.05);there was no significant difference in Apgar score between the two groups (P>0.05).The percentage of POP-QⅠ in the observation group was 92.00%,higher than 64.00% in the control group (P<0.05);the muscle strength of type Ⅰ and Ⅱ muscle fibers in the observation group were significantly higher than those in the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of neonatal asphyxia between the two groups (P>0.05).The incidence of delayed healing,puerperal infection,postpartum urinary retention and postpartum pain in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:The unprotected perineum combined with painless delivery can effectively reduce the pain,postpartum hemorrhage,shorten the hospitalization time,effectively maintain the function of pelvic floor muscles,and reduce the incidence of complications.