摘要
目的研究无保护会阴接生联合会阴阻滞麻醉对自然分娩的临床价值,为产妇分娩的方式选取提供参考。方法随机选择2017年6月～2018年6月我院接收的4803例产妇,按随机数字表法,将其分为两组,对照组采用常规的方式生产,于宫口开全后平卧位,用常规的保护会阴方法接产;观察组采取无保护会阴接生配合会阴阻滞麻醉的方法生产。比较两组的产程、出血量、产妇会阴和新生儿的情况等,统计观察组体位的选取种类。结果两组第一产程和出血量相近,差异无统计学意义(P> 0.05),观察组的第二产程明显少于对照组,差异有统计学意义(P <0.05),观察组新生儿Apgar评分要优于对照组(P <0.05)。观察组的会阴疼痛、会阴侧切者比例较少,而会阴完整、Ⅰ度撕裂者的比例较多,与对照组比较差异有统计学意义(P <0.05);两组均无会阴Ⅲ度撕裂伤,在会阴Ⅱ度撕裂伤的比例上也相近(P> 0.05)。观察组采取半坐位1123例(46.8%),侧卧位641例(26.7%),中途有体位更换480例(20.0%),站位31例(1.3%),蹲位127例(5.3%)。结论对足月单胎行自然分娩的产妇,无保护的会阴接生联合会阴阻滞麻醉可以减少分娩不适及产后出血,减少会阴损伤,值得推广。
Objective To study clinical values of unprotected perineum delivery combined with perineum block anesthesia in natural deliveryand to provide references for the choice of maternal delivery.Methods 4803 parturient women who were admitted to our hospital from June 2017 to June 2018 were randomly selected.According to random number table method,they were divided into two groups.Parturient women in the control group adopted the conventional way of delivery.They lay down in the supine position after the opening of theuterine orificeand delivered the baby with the conventional method of protecting the perineum.The observation group adopted unprotected perineum delivery combined with perineum block anesthesia.The stage of labors,blood loss,perineum condition and neonatal status were compared between the two groups.The types of position selection of the observation group were recorded.Results The first stage of labor and blood loss were similar in the two groups,and the difference was not statistically significant(P>0.05).The second stage of labor in the observation group was significantly less than that in the control group,and the difference was statistically significant(P<0.05).The Apgar score of the newborns in the observation group was better than that of the control group(P<0.05).Cases of perineal pain and lateral episiotomy were less in the observation group while cases of perineal integrity and grade Ⅰ lacerations were more.The difference between the observation group and the control group was statistically significant(P<0.05).There was no perineallacerationof Ⅲ degree in both groups,and the proportion of perineallacerations of Ⅱ degree was similar(P>0.05).In the observation group,1123 cases(46.8%)were in semi-sitting position,641 cases(26.7%)were in lateral lying position,480 cases(20.0%)were of position change,31 cases(1.3%)were in standing position and 127 cases(5.3%)were in squatting position.Conclusion Forparturient womenwith singleton term who undergo natural delivery,unprotected perineum delivery com
作者
叶晓丹
莫燕虹
林姗姗
YE Xiaodan;MO Yanhong;LIN Shanshan(Yangjiang Maternal and Child Health Hospital,Yangjiang 529500,China)
出处
《中国医药科学》
2019年第2期100-103,共4页
China Medicine And Pharmacy
关键词
分娩
无保护
会阴
第二产程
会阴阻滞麻醉
Delivery
Unprotected
Perineum
Second stage of labor
Perineum block anesthesia
