CAJ | 학술논문

目的探讨限制会阴切开在产钳术中的应用价值.方法对北京市海淀区妇幼保健院2013年6至12月期间分娩的311例低位产钳助产术病例进行分析,其中行限制性会阴侧切的117例产妇为研究组,行常规会阴侧切的194例产妇为对照组,从多个指标比较两种方式对母婴的影响.结果研究组产时出血量、产后出血量、会阴Ⅰ、Ⅱ度裂伤、产后24 h会阴疼痛VAS评分、会阴缝合时间均低于对照组,P＜0.05.会阴血肿、产褥感染、尿潴留发生率、产后住院时间与对照组差异无统计学意义,P＞0.05.新生儿窒息率、新生儿产伤、新生儿ICU入住率两组差异无统计学意义,P＞0.05.结论限制会阴切开在低位产钳术助产中的应用,降低会阴切开率、减少产妇出血量及产道损伤,减轻母亲的痛苦,未增加新生儿窒息和产伤,提高阴道分娩质量,是微创理念的体现,值得在临床推广.
목적 탐토한제회음절개재산겸술중적응용개치.방법 대북경시해정구부유보건원2013년6지12월기간분면적311례저위산겸조산술병례진행분석,기중행한제성회음측절적117례산부위연구조,행상규회음측절적194례산부위대조조,종다개지표비교량충방식대모영적영향.결과 연구조산시출혈량、산후출혈량、회음Ⅰ、Ⅱ도렬상、산후24 h회음동통VAS평분、회음봉합시간균저우대조조,P＜0.05.회음혈종、산욕감염、뇨저류발생솔、산후주원시간여대조조차이무통계학의의,P＞0.05.신생인질식솔、신생인산상、신생인ICU입주솔량조차이무통계학의의,P＞0.05.결론 한제회음절개재저위산겸술조산중적응용,강저회음절개솔、감소산부출혈량급산도손상,감경모친적통고,미증가신생인질식화산상,제고음도분면질량,시미창이념적체현,치득재림상추엄.
Objective To explore the restrictive use of episiotomy for low forceps delivery.Methods A total of 311 low forceps delivery women at ≥37 weeks of gestation with live singleton cephalic pregnancies were recruited from June 2013 to December 2013 at our hospital.Among whom,117 women underwent no episiotomy another 194 had mediolateral episiotomy.The maternal and neonatal outcomes of two types of episiotomy were compared.Results The amount of intra and post-partum hemorrhage,Ⅰ-Ⅱ perineal tearing,time of perineal suturing,perineal pain severity of post-partum 24 h significantly decreased than control group (P ＜ 0.05).No statistical significant inter-group differences existed in perineal hematoma,postnatal infection,urinary retention or length of stay after childbirth (P ＞ 0.05).And no statistically significant inter-group differences existed in incidence rates of neonatal asphyxia,neonatal birth trauma and newborns into neonatal intensive care unit (NICU) (P ＞ 0.05).Conclusion During low forceps delivery,restrictive use of episiotomy may decrease the rate of episiotomy,reduce the amount of hemorrhage,minimize maternal injury,relieve pain and have no adverse effects on neonatal morbidities.And it improves the quality of vaginal delivery and demonstrate the concept of mini-invasiveness so that it is worthy of wider promotions.