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目的探讨限制性会阴切开在临床的可行性和安全性,比较会阴侧切与会阴直切两种术式母儿的结局。方法选取2012年1月至2014年1月住院分娩的头位初产妇280例,其中98例行限制会阴切开术(A组),102例行常规会阴侧切术(B组),80例行常规会阴直切术(C组)。观察三组分娩方式在产时、产后对母儿的影响。结果 A组在会阴完整率、产时出血量、住院时间、产后恢复性交时间、性生活满意度方面均显著优于B、C两组,差异有统计学意义(P<0.01);而B、C两组以上各指标比较差异未见统计学意义(P>0.05)。A组会阴裂伤率明显高于B、C两组,差异有统计学意义(P<0.01);B、C两组会阴裂伤率及产后会阴疼痛比较差异亦有统计学意义(P<0.05)。三组间第二产程、预防性使用抗生素、产褥感染、新生儿窒息、新生儿体质量、尿失禁、盆腔脏器脱垂等比较差异未见统计学意义(P>0.05)。结论对于初产妇而言,在无绝对会阴切开指征时不建议常规行会阴切开来缩短产程,必须会阴切开时,应根据胎儿大小、会阴体的条件及接产人员的技术选择切口,以减少不必要的重度裂伤及会阴疼痛。
Objective To investigate the feasibility and safety of restrictive perineal incision in clinical practice and to compare the outcome of two surgical masters, ie perineal lateral incision and perineal incision. Methods One hundred and twenty-eight cases of first-born primipara inpatient delivery between January 2012 and January 2014 were enrolled in this study. Among them, 98 patients underwent perineal incision (group A), 102 patients underwent routine episiotomy (group B), 80 patients Conventional perineal resection (C group). Observe the impact of three modes of delivery in the delivery, postpartum on the mother and child. Results In group A, the perineal complete rate, the amount of bleeding during delivery, length of hospital stay, postpartum recovery time of sexual intercourse and sexual life satisfaction were significantly better than those in group B and C (P <0.01) There was no significant difference between two groups of C indicators (P> 0.05). The rate of perineal laceration in group A was significantly higher than that in group B and C (P <0.01). There was also significant difference in the rate of perineal laceration and postpartum episiotral pain between groups B and C (P <0.05 ). No significant difference was found between the three groups in the second stage of labor, prophylactic use of antibiotics, puerperal infection, neonatal asphyxia, neonatal body mass, urinary incontinence, pelvic organ prolapse, etc. (P> 0.05). Conclusions For primiparous women, incision of perineum is not recommended for permanent perineal incision without shortening of perineum incision. When perineal incision must be performed, the incision should be made according to the size of the fetus, the condition of the perineal body, and the technique of the receiving person , To reduce unnecessary severe laceration and perineal pain.