体位干预联合适度会阴保护在改善产妇分娩结局及盆底功能中的应用

Effects of postural intervention and appropriate protection of perineum on maternal delivery outcomes and pelvic floor function

目的:探讨体位干预联合适度保护会阴对产妇分娩结局及盆底功能的影响。方法:选择2019年10月—2020年10月产科收治的自然分娩产妇320例,按随机数字表法分成对照组和观察组,每组160例。对照组实施产科常规性指导,观察组对会阴实施体位干预结合适度保护,对比两组产程、盆底功能、分娩结局状况。结果:观察组第1产程、第2产程及总产程时间短于对照组(P<0.05),而活跃期视觉模拟评分(VAS)低于对照组(P<0.05)。观察组产后2 h出血率、会阴撕裂、中途转剖宫产率、新生儿窒息率低于对照组(P<0.05)。观察组Ⅰ类肌纤维损伤、Ⅱ类肌纤维损伤、压力性尿失禁、性功能障碍等发生率低于对照组,产妇满意率高于对照组,差异有统计学意义(P<0.05)。结论:对会阴实施体位干预结合适度保护可减少自然分娩产妇出现不良妊娠结局的概率,减轻产妇盆底功能损伤,有利于产妇产后康复,提高产妇分娩满意率。

Objective:To investigate the effects of body intervention and appropriate protection of perineum on maternal delivery outcomes and pelvic floor function.Methods:All 320 cases of natural births in this department were selected from October 2019 to October 2020.The patients were divided into observation group(n=160) and control group(n=160) according to the random number table.The control group was given with routine obstetric guidance and observation group was implemented with postural intervention with appropriate protection of the perineum.The maternal delivery process,delivery outcomes,and pelvic floor function of two groups were compared.Results:The first,second and total labor time of observation group were shorter than control group(P<0.05),while the visual analogue score(VAS) was lower than control group(P<0.05).The of bleeding rate,perineal laceration,cesarean section rate,and neonatal asphyxia rate at 24 hours postpartum of observation group was lower than control groups(P<0.05).The incidence of type Ⅰ muscle fiber injury,type Ⅱ muscle fiber injury,stress urinary incontinence,and sexual dysfunction of observation group was lower than control group(P<0.05),while the maternal satisfaction rate was higher than control group(P<0.05).Conclusion:Postural intervention combined with proper protection of perineum can effectively reduce the adverse pregnancy outcomes of natural childbirth,alleviate the pelvic floor function damage of the mother,facilitate the postpartum recovery of the mother,and improve the satisfaction rate of the childbirth.