阴道分娩后严重会阴裂伤的热点问题及管理策略

Hot issues and management strategies for severe perineal tears following vaginal delivery

严重会阴裂伤包括单纯直肠损伤的直肠扣眼裂伤及引起肛门括约肌和肛门直肠损伤的产科肛门括约肌损伤。严重会阴裂伤可引起慢性疼痛、大便失禁、性功能障碍、阴道直肠瘘等一系列远期并发症,严重影响生活质量。国家卫生健康委员会将"降低阴道分娩并发症发生率"列入国家医疗质量安全改进十大目标之中。本文探讨严重会阴裂伤的热点问题,提出适于我国国情的管理意见,希望在降低剖宫产率及会阴切开率的管理目标基础上正确防治严重会阴裂伤,减少近远期并发症。

Severe perineal tears include isolated rectal injuries such as rectal buttonhole tears and obstetric anal sphincter injuries that cause damage to the anal sphincter and anorectal region.Severe perineal tears can lead to a series of long-term complications,including chronic pain,fecal incontinence,sexual dysfunction,and rectovaginal fistulas,severely affecting the quality of life.The National Health Commission has listed"Reducing the Incidence of Complications from Vaginal Delivery"as one of the top ten national medical quality and safety improvement goals.This article discusses the hot issues surrounding severe perineal tears and proposes management recommendations suitable for China's national conditions.It aims to correctly prevent and treat severe perineal tears,reducing short-and long-term complications,based on the management goals of lowering the cesarean section rate and episiotomy rate.