CAJ | 학술논문

目的：探讨单手保护会阴接产法与传统保护会阴接产法的会阴条件评估、侧切率及裂伤程度的比较，以提高助产技能及评估能力，减少会阴损伤。方法采用前瞻性临床随机对照研究，研究对象为足月、头位、无妊娠合并症与并发症，无胎儿窘迫经阴道分娩者。其中研究组293例，对照组294例，研究组采用单手保护会阴接产法，对照组采用传统保护会阴接产法，观察两组产妇会阴条件、新生儿体质量、会阴侧切及裂伤情况。结果两组会阴体长度、会阴弹性、新生儿体质量差异无统计学意义（P＞0．05），研究组会阴侧切率显著低于对照组，两组分别为17．1％、40．5％，研究组会阴裂伤程度显著低于对照组，差异均有统计学意义（ P＜0．05），两组会阴Ⅲ度裂伤发生率差异无统计学意义（P＞0．05），两组均无Ⅳ度裂伤发生。结论单手保护会阴接产法较传统保护会阴接产法能提高会阴评估能力，降低会阴侧切率，减轻会阴裂伤程度，并不增加会阴Ⅲ、Ⅳ度裂伤的发生率。
목적：탐토단수보호회음접산법여전통보호회음접산법적회음조건평고、측절솔급렬상정도적비교，이제고조산기능급평고능력，감소회음손상。방법채용전첨성림상수궤대조연구，연구대상위족월、두위、무임신합병증여병발증，무태인군박경음도분면자。기중연구조293례，대조조294례，연구조채용단수보호회음접산법，대조조채용전통보호회음접산법，관찰량조산부회음조건、신생인체질량、회음측절급렬상정황。결과량조회음체장도、회음탄성、신생인체질량차이무통계학의의（P＞0．05），연구조회음측절솔현저저우대조조，량조분별위17．1％、40．5％，연구조회음렬상정도현저저우대조조，차이균유통계학의의（ P＜0．05），량조회음Ⅲ도렬상발생솔차이무통계학의의（P＞0．05），량조균무Ⅳ도렬상발생。결론단수보호회음접산법교전통보호회음접산법능제고회음평고능력，강저회음측절솔，감경회음렬상정도，병불증가회음Ⅲ、Ⅳ도렬상적발생솔。
Objective To compare the perineum condition assessment ,perineum episiotomy rate and laceration degree between the single hand perineum protection delivering method and traditional perineum protection delivering method in order to improve the midwifery skills and assessment ability ,and reduce the perineum trauma .Methods The prospectively randomized clinical study was adopted with the parturients with full‐term ,head position ,without pregnancy comorbidities ,complications and fetal distress ,and vaginal delivery as the research subjects .Among them , 293 cases were in the research group and 294 cases in the control group .The research group adopted the single hand perineum protection delivering method ,while the control group adopted the traditional perineum protection delivering method .The perineum condition ,neonatal weight ,perineum episiotomy and perineum laceration were observed in the two groups .Results The perineum lengths ,perineum elasticity and neonatal weight had no statistical differences (P>0 .05);the episiotomy rate in the research group was significantly lower than that in the control group(17 .1%vs .40 .5% ) ,the perineum laceration degree in the research group was significantly lower than that in the control group ,the differences were statistically significant(P<0 .05);the occurrence rate of degree Ⅲ perineum laceration had no statistically significant difference between the two groups(P> 0 .05);no degree Ⅳ perineum laceration oc‐curred in the two groups .Conclusion The single hand perineum protection delivering method can elevated the perine‐um assessment ability compared with the traditional perineum protection delivering method ,decreases the episiotomy rate and reduces perineum laceration without increasing the occurrence rate of degree Ⅲ and Ⅳ perineum laceration .