无保护会阴接生法在初产妇自然分娩中的应用效果观察

Application of unprotected perineum delivery technique for natural childbirth in primiparas

目的观察无保护会阴接生法在初产妇自然分娩中的应用效果。方法选取2019年1月至2020年9月在滕州市中心人民医院住院自然分娩的初产妇260例为研究对象,采用随机数字表法分为研究组(n=130)和对照组(n=130)。研究组采取无保护会阴接生法,对照组采取传统方法接生。比较两组初产妇产时及产后相关指标。结果研究组与对照组初产妇的会阴Ⅰ°裂伤率分别为71.52%、29.23%,会阴Ⅱ°裂伤率分别为7.16%、3.16%,会阴侧切率分别为21.32%、67.51%,差异均有统计学意义(χ^(2)=7.19、7.03、8.35,均P<0.05);研究组与对照组初产妇的住院时间分别为(3.27±5.79)d、(5.18±7.26)d,产后会阴疼痛数字评分法(NRS)评分分别为(1.23±2.51)分、(3.24±2.79)分,产后并发症发生率分别为3.33%、11.67%,差异均有统计学意义(t=2.23、2.06,χ^(2)=2.52,均P<0.05);两组初产妇的第二产程时间、新生儿Apgar评分比较,差异均无统计学意义(均P>0.05)。结论无保护会阴接生法可明显降低会阴侧切率,减轻会阴裂伤,减轻初产妇疼痛,减少产后并发症,缩短住院时间,提高产科质量。

Objective To investigate the application effects of unprotected perineum delivery technique for normal vaginal delivery in primiparas.Methods A total of 260 primiparas who underwent natural childbirth in Tengzhou Central People's Hospital between January 2019 and September 2020 were included in this study.They were randomly assigned to undergo childbirth either with an unprotected perineum delivery technique(study group,n=130)or the conventional delivery technique(control group,n=130).Delivery-related indicators were compared between the two groups.Results The rate of first-degree perineal tear in the study and control groups was 71.52%and 29.23%,respectively,the rate of second-degree perineal tear were 7.16%and 3.16%,respectively,and the episiotomy rate in the two groups were 21.32%and 67.51%,respectively.There were significant differences in rate of first-degree perineal tear,rate of second-degree perineal tear and episiotomy rate between the two groups(χ^(2)=7.19,7.03,8.35,all P<0.05).The length of hospital stay in the study and control group was 3.27±5.79 days and 5.18±7.26 days,respectively.The numerical rating scale score of postpartum perineal pain in the two groups was 1.23±2.51 points and 3.24±2.79 points,respectively.The incidence of postpartum complications was 3.33%and 11.67%,respectively.There were significant differences in length of hospital stay,numerical rating scale score of postpartum perineal pain and incidence of postpartum complications between the two groups(t=2.23,2.06,χ^(2)=2.52,all P<0.05).There were no significant differences in length of second stage of labor and Apgar score in new born infants between the study and control groups(all P>0.05).Conclusion Unprotected perineum delivery technique can greatly decrease episiotomy rate,alleviate perineal tear,reduce pain,reduce complications,shorten length of hospital stay,and improve quality of obstetric care.