医学研究与教育 ›› 2014, Vol. 31 ›› Issue (2): 83-86.DOI: 10.3969/j.issn.1674-490X.2014.02.021

• 护理研究 • 上一篇    下一篇

无保护接生的可行性研究

聂津,牛保兰,董文敬,乔朋,栗玉   

  1. 唐县人民医院产房,河北唐县,072350
  • 收稿日期:2016-09-29 修回日期:2016-09-29 出版日期:2014-04-25 发布日期:2014-04-25

Feasibility study on unprotected delivery

NIE Jin,NIU Baolan,DONG Wenjing,QIAO Peng,LI Yu   

  • Received:2016-09-29 Revised:2016-09-29 Online:2014-04-25 Published:2014-04-25

摘要: 目的:探讨会阴无保护接生技术在低危孕妇正常分娩中的应用效果。方法便利抽样法选择2013年1-9月在唐县人民医院拟经阴道分娩的初产妇360例为研究对象。按随机数字表法将其分为观察组和对照组,每组180例。观察组于宫口开全胎头着冠后,助产士指导产妇屏气和哈气,在无保护会阴状态下分娩;对照组采用传统保护会阴的接生方法进行接产。比较两组产妇软产道裂伤、产后出血、产程时间、新生儿窒息等情况。结果观察组产妇的会阴侧切率为22.2%,而对照组的会阴侧切率为75.0%,差异有统计学意义(P<0.001);产后出血率(2.2%)较对照组(13.9%)显著降低(P<0.001);两组产妇均未出现会阴III °裂伤,其中观察组I °裂伤率高于对照组,而II °裂伤率低于对照组(P=0.001);观察组三个产程及总产程用时均比对照组短,两组比较差异有统计学意义(P<0.001)。两组产妇的新生儿窒息率差异无统计学意义(P>0.05)。结论会阴无保护接生可降低会阴侧切率,减少会阴切口感染,提高分娩舒适感,促进自然分娩率,同时降低产后出血的发生率,具有可行性。

关键词: 会阴无保护, 初孕妇, 正常分娩

Abstract: Objective To discuss application and effects of technique of unprotected perineum delivery in pregnant women. Methods 360 primiparas expecting to have vaginal delivery from January to September 2013 in Tangxian People’s Hospital were selected by convenient sampling and randomly and equally divided into the observation group and the control group. In observation group, midwife would direct the pregnant women to hold her breath and breathe when uterine neck whole opened and fetal head crowned and helped them give birth to a baby under state of unprotected perineum. In the control group, traditional delivery method was chosen. Comparison of soft birth canal laceration, postpartum hemorrhage, duration of delivery, neonatal asphyxia and so on between the two groups was made. Results Rate of lateral episiotomy and of postpartum hemorrhage in the observation group were demonstrated 22.2%and 2.2%, which were obviously lower than that of 75.0%and 13.9%in the control group. The difference had statistical signiifcance (P<0.001). Both groups had no III laceration. However, occurrence rate of I laceration observed was higher in the observation group than that in the control group, on the contrary, rate of II laceration was lower (P=0.001). Duration of 3 birth processes or the whole delivery in the observation group were shorter, and difference between the two groups had statistical significance (P<0.001). There was no statistical significance in the difference of neonatal asphyxia between the two groups (P>0.05). Conclusion Unprotected perineum delivery could reduce occurrence rate of lateral episiotomy and infection of perineum incision, improve comfort of delivery and occurrence rate of natural delivery, and meanwhile decrease occurrence rate of postpartum hemorrhage. Therefore, the unprotected perineum delivery was feasible in clinical practices.

Key words: unprotected perineum, primipara, normal delivery

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