椎管内麻醉下适度会阴保护对阴道分娩的影响

Effect of moderate perineal protection under intraspinal anesthesia on vaginal delivery

目的探讨实施无痛分娩下,阴道分娩过程中适度会阴保护对母儿结局的影响。方法选取2017年1月-2018年12月天津市和平新世纪妇儿医院收治的216例产妇为研究对象,分娩过程均实施椎管内麻醉分娩镇痛,其中2018年1-12月在采用适度会阴保护的107例分为观察组,2017年1-12月采用传统会阴保护的109例分为对照组,比较两组会阴完整率、会阴裂伤程度、产后出血率、新生儿窒息率、会阴伤口延期愈合率、产后会阴痛率。结果观察组会阴完整率为33.64%,高于对照组的17.43%;观察组产后出血率为1.87%,低于对照组的13.76%;观察组产后会阴痛率为17.76%,低于对照组的31.19%,差异均有统计学意义(P<0.05)。两组新生儿窒息率、会阴伤口延期愈合率差异无统计学意义(P>0.05)。结论在实施无痛分娩下,阴道分娩过程中适度保护会阴,可以有效减少会阴裂伤的发生,降低产后出血及会阴痛率,值得临床推广应用。

Objective To investigate the effect of moderate perineal protection on maternal and neonataloutcomes during vaginal delivery under painless delivery.Methods 216 parturients admitted to Tianjin Heping New Century Hospital for Women and Children from January 2017 to December 2018 were selected as the research objects,all parturients were given intraspinal anesthesia and labor analgesia during delivery.107 cases with moderate perineal protection during vaginal delivery from January to December 2018 were divided into observation group and 109 cases with traditional perineal protection from January to December2017 were divided into control group.The perineal integrity rate,perineal laceration degree,postpartum hemorrhage rate,neonatal asphyxia rate,delayed perineal wound healing rate and postpartum perineal pain rate were compared between the two groups.Results The perineal integrity rate was 33.64%of the observation group,which was higher than 17.43%of the control group;the postpartum hemorrhage rate was1.87%of the observation group,which was lower than 13.76%of the control group;the perineal pain rate was 17.76%of the observation group,which was lower than 31.19%of the control group,the differences were statistically significant(P<0.05).There was no significant difference in neonatal asphyxia rate and delayed perineal wound healing rate between the two groups(P>0.05).Conclusion Under painless delivery,proper protection of perineum during vaginal delivery could effectively reduce the occurrence of perineal laceration,cut down the rate of postpartum hemorrhage and perineal pain,which was worthy of clinical popularization and application.