摘要
目的探讨自由体位联合无保护会阴助产的分娩结局及对产后盆底功能的影响,并与传统体位联合会阴保护的助产方法作对比。方法选取浙江省丽水市中心医院2022年1~12月接受自然分娩的124例产妇的临床资料,根据助产方式分为自由体位联合无保护组和传统助产联合会阴保护组各62例。观察两组产程时间、产后出血量、疼痛评分、会阴裂伤程度、会阴侧切率、术中转剖宫产率、新生儿10分钟Apgar评分、产妇满意度以及产后盆底功能。结果(1)分娩情况。自由体位联合无保护组第一、第二、第三以及总产程时间均明显短于传统体位联合会阴保护组(P<0.01),产后出血明显少于传统体位联合会阴保护组(P<0.01),产妇Ⅲ级疼痛发生率明显低于传统体位联合会阴保护组(P<0.01)。(2)分娩结局。自由体位联合无保护组有2例(3.23%)转剖宫产,转剖宫产率低于传统体位联合会阴保护组(8例,12.90%)(P<0.05);两组新生儿10分钟Apgar评分≥8分者差异无统计学意义(P>0.05);自由体位联合无保护组产妇满意度高于传统体位联合会阴保护组(P<0.05)。(3)会阴情况及盆底功能。自由体位联合无保护组Ⅲ度会阴裂伤发生比例及会阴侧切比例明显低于传统体位联合会阴保护组,自由体位联合无保护组盆底功能障碍比例为48.39%,明显低于传统体位联合会阴保护组67.74%(P<0.05)。结论自由体位联合无保护助产技术应用于自然分娩可缩短产程时间、减少产后出血量、降低会阴侧切率及会阴裂伤程度,减轻产妇分娩疼痛,保护产妇盆底功能,提高产妇满意度,且未增加新生儿窒息风险,该分娩方法值得临床推广使用。
Objective To investigate the outcome of free position combined with unprotected perineal midwifery and its effect on postpartum pelvic floor function,and compare it with traditional position combined with perineal protection.Methods The clinical data of 124 cases of natural delivery in Lishui Central Hospital of Zhejiang Province from January 2022 to December 2022 were selected.According to the midwifery methods,they were divided into free position combined with unprotected group and traditional midwifery combined with perineal protection group,with 62 cases each.The duration of labor,postpartum blood loss,pain score,perineal laceration degree,perineal lateral resection rate,intraoperative cesarean section ratio,10-minute Apgar score of newborns,maternal satisfaction and postpartum pelvic floor function were observed in the two groups.Results(1)Delivery situation.The first,second,third and total labor time of free posture combined with no protection group were significantly shorter than those of traditional posture combined with perineum protection group(P<0.01).Postpartum hemorrhage in the free postural group combined with no protection was significantly less than that in the traditional postural group combined with perineal protection(P<0.01).The incidence of gradeⅢpain in free postural group combined with unprotected perineum was significantly lower than that in traditional postural group combined with protected perineum group(P<0.01).(2)Delivery outcome.There were 2 cases(3.23%)in the free position combined with no protection group,and 8 cases(12.90%)in the traditional position combined with perineal protection group(P<0.05).There was no significant difference in 10-minute Apgar score≥8 between the two groups(P>0.05).The satisfaction of women in free posture combined with no protection group was higher than that in traditional posture combined with perineal protection group(P<0.05).(3)Perineal condition and pelvic floor function.The proportion of third-degree perineal laceration and lateral perineal incis
作者
沙菁
SHA Jing(Lishui Central Hospital,Lishui 323020,China)
出处
《浙江实用医学》
2023年第4期303-307,共5页
Zhejiang Practical Medicine
关键词
自由体位联合无保护会阴助产
自然分娩
盆底功能
母婴结局
free position combined unprotected perineal midwifery
natural delivery
pelvic floor function
maternal and infant outcome
