摘要
目的探讨改良右手中食指扩张阴道助娩与新生儿缺氧缺血性脑病(HIE)的发病及与产妇会阴完整性的关系。方法对照组采用传统保护会阴法助娩,观察组采用改良右手中食指扩张阴道助娩。观察组于宫缩间隙期以涂有消毒石蜡油的右手中食指伸入阴道内,使用特定指法对阴道进行扩张,宫缩时停止。如此反复多次滑行扩张牵拉,可多次涂消毒石蜡油于术指,当胎头着冠时停止扩张,并将术指石蜡油擦干,右手保护会阴,直至胎体娩出。婴儿娩出后立即由儿科医师、助产师共同参与新生儿复苏、新生儿1分钟Apgar评分、HIE临床分度及新生儿、产妇异常情况干预。结果观察组在新生儿1分钟Apgar评分、中至重度HIE发病率、产妇会阴完整率、会阴裂伤率及会阴侧切率等方面,均明显优于对照组,均经χ2检验,P<0.01或<0.05,差异具有统计学意义。结论新生儿HIE发病率的下降,产妇会阴完整性的提高,会阴裂伤率及会阴侧切率的下降,与采用改良右手中食指扩张阴道助娩密切相关,值得推广应用。
Objective To study the relationship among the reform of the index and forefinger vagina expansion delivery,hypoxic ischemic encephalopathy(HIE) and maternal perineum integrality.Methods The control group got the traditional perineum protection delivery,while the observation group received the index and forefinger vagina expansion delivery.As for the observation group,the right index and forefinger coated with disinfection paraffin oil were inserted into the vagina during the interval between uterine contractions,using specific fingering to expand the vagina.The sliding expansion traction and the coating could be repeated many times until the time of crowning of head,when the traction could be stopped and the disinfection paraffin oil could be wiped from the fingers,with the right hand protecting the perineum until the fetus expulsion.On expulsion,pediatricians together with midwives,dealt with neonatal resuscitation,neonatal 1 minute Apgar score,HIE clinical grading and neonatal and maternal abnormal situation intervention.Results The observation group obviously had better effects than the control group,in neonatal 1 minute Apgar score,moderate or severe HIE,and in the rate of maternal perineum integrality,perineal laceration and lateral episiotomy.There was significant difference between the results of the two groups(P<0.01 or 0.05 by χ2 Test).Conclusion The lower incidence of hypoxic ischemic encephalopathy(HIE),the improvement of maternal perineum integrality,and the lower rate of perineal laceration and lateral episiotomy are closely related to the reform of the index and forefinger vagina expansion delivery,and therefore it is worth spreading and application.
出处
《黑龙江医学》
2013年第6期459-461,共3页
Heilongjiang Medical Journal
关键词
分娩
助产
护理
缺氧缺血性脑病
新生儿
Delivery
Miwifery
Nursing
Hypoxic ischemic encephalopathy(HIE)
The neonatal
