CAJ | 학술논문

目的：比较传统的会阴侧切接生方法与无保护会阴接生法对分娩结局、会阴伤口的影响。方法传统的会阴侧切组81例产妇用右手托肛会阴保护接生方法，无保护会阴接生组184例产妇不用手扶持会阴的新接生方法。对比两组第二产程时间、新生儿情况、产后出血、会阴伤口疼痛肿胀程度、会阴伤口愈合情况。结果两组孕妇年龄、孕周、新生儿体重比较差异无统计学意义(P >0．05)；两组产妇在第二产程时间、Apgar 评分、产后出血量的比较差异无统计学意义(P >0．05)；两组产妇会阴疼痛肿胀程度比较差异有统计学意义(P <0．05)；无保护会阴组产妇伤口愈合分期明显高于会阴侧切组，差异有统计学意义(P <0．05)。结论改良后的接生方法可降低会阴伤口疼痛肿胀程度，提高会阴伤口愈合分期，不增加第二产程时间及新生儿窒息。该方法操作简单、安全、有效，有益于保护孕产妇安全，减少会阴体损伤，值得临床推广使用。
목적：비교전통적회음측절접생방법여무보호회음접생법대분면결국、회음상구적영향。방법전통적회음측절조81례산부용우수탁항회음보호접생방법，무보호회음접생조184례산부불용수부지회음적신접생방법。대비량조제이산정시간、신생인정황、산후출혈、회음상구동통종창정도、회음상구유합정황。결과량조잉부년령、잉주、신생인체중비교차이무통계학의의(P >0．05)；량조산부재제이산정시간、Apgar 평분、산후출혈량적비교차이무통계학의의(P >0．05)；량조산부회음동통종창정도비교차이유통계학의의(P <0．05)；무보호회음조산부상구유합분기명현고우회음측절조，차이유통계학의의(P <0．05)。결론개량후적접생방법가강저회음상구동통종창정도，제고회음상구유합분기，불증가제이산정시간급신생인질식。해방법조작간단、안전、유효，유익우보호잉산부안전，감소회음체손상，치득림상추엄사용。
Objective To compare the effect of unprotected perineum delivery technique and episiotomy delivery tech-nique on outcomes of delivery and the perineal wound. Methods A prospective follow-up study of 265 women with spontaneous vaginal delivery in thehospital from January to November 2013. These women were randomized into the unprotected perineum deliv-ery group(184)and the control group(81),that is routine episiotomy delivery technique group. The time of second stage of labor, newborns conditions,the blood loss,perineal pain and woundhealing stage in the two groups were compared. Results No signifi-cant difference among the pariae’s age,newborn weight,the second stage time,the scores of APCAR and the postpartum blood loss was found between groups. Women who delivered with unprotected perineum delivery techniquehad significantly lower perineal pain scores compared to women whohad an episiotomy technique. The perineal woundhealing stage in the unprotected perineum delivery technique group was better than the control group. Conclusion The unprotected perineum delivery technique can lower the level of perineal pain and decrease the degree of the wound swelling,improve the woundhealing stage,meanwhile,not to increase the time of the second stage of labor and neonatal asphyxia. This technique is simple,safe,effective,beneficial to the protection of maternal safety,and to reduce the perineal body injury. It is worthy of clinical application.