基于孕产一体化管理构建阴道分娩后会阴疼痛的防治管理方案

Development of a perineal pain management scheme after vaginal delivery based on integrated maternity and childbirth

目的构建孕产一体化管理阴道分娩后会阴疼痛管理方案。方法结合文献基础,于2022年11月至2023年4月采用文献分析、德尔菲法确定阴道分娩后会阴疼痛防治方案。共对21名专家进行2轮函询。结果函询问卷的有效回收率均为100.0%,2轮专家权威系数分别为0.930、0.935,2轮专家协调系数分别为0.109(P<0.001)、0.392(P<0.001),满分率最高100%,最终形成包含产前预防、产时保护和产后治疗的阴道分娩后会阴疼痛管理方案,其中一级指标3个、二级指标15个和三级指标40个。结论阴道分娩后会阴疼痛管理方案具有科学性及可靠性,为阴道分娩后会阴疼痛的预防和治疗提供科学的参考依据。

Objective To propose an integrated management scheme for perineal pain after vaginal delivery.Methods Literature review and Delphi inquiry were conducted to propose the perineal pain management scheme after vaginal delivery from November 2022 to April 2023.A total of 21 experts were consulted with 2 rounds of correspondence.Results Questionnaires collected from the two rounds of correspondence consultations were both at 100.0%.The expert authority coefficients for the two rounds were 0.930 and 0.935,respectively,with the expert coordination coefficients of the two rounds at 0.109(P<0.001)and 0.392(P<0.001),full mark rate 100%.A total of 3 primary items,15 secondary items and 40 tertiary items were summarised for the perineal pain management scheme after vaginal delivery in relation to prenatal prophylaxis,intrapartum protection and postnatal treatment.Conclusions The developed perineal pain management scheme after vaginal delivery is scientific and reliable.It provides a scientific reference for the prevention and treatment of perineal pain after vaginal delivery.