无保护会阴分娩的临床探讨.docVIP

无保护会阴分娩的临床探讨 　　【摘要】目的 通过观察产妇无保护会阴状态下分娩会阴裂伤情况, 降低会阴切开率, 减少产科创伤, 提高“自然分娩”的成功率。方法 将本院2013年8~12月间正常分娩的的产妇100例, 分为观察组和对照组各50例, 观察组入院后给予讲解“自然分娩”的好处, 宫口开全胎头着冠后, 助产士指导产妇屏气和哈气, 疼痛时屏气, 不疼痛时哈气, 在无保护会阴状态下分娩, 对照组在宫口开全、胎拨露后, 传统托肛保护会阴的接生方法进行会阴分娩, 观察两组“自然分娩”会阴裂伤情况。结果 产妇会阴裂伤例数及程度比较差异无统计学意义(P0.05)。结论 无保护会阴接生方法简单、实用, 对产妇及新生儿均无不良影响, 降低了产妇会阴侧切率, 值得在临床推广。 　　【关键词】自然分娩；无保护会阴；会阴侧切 　　 　　Clinical discussion on unprotected perineum delivery CHEN Li-li. Kaiping Maternal and Child Health Care, Kaiping 529300, China 　　【Abstract】ObjectiveTo reduce episiotomy rate, improve the success rate of natural deliveryand lesse trauma through observation on perineal lacerations of maternal without the protection of perineum. MethodsFrom August to December in 2003, 100 cases of normal delivery of maternal were divided into the observation group and the control group, each 50 cases, the midwife explained the benefits of natural delivery guided breath when their wides were opened to follow the head in the observation group. Holding breath with pain and holding breath with no pain for them to delivery without the protection of perineum. The control group were protected perineal when their wides were opened to follow the head. ResultsThere were no differences in the numbers and severity of perineal laceration(P0.05). ConclusionThis simple and practical way was worthy in clinical promotion because it reduces the episiotomy rate and has no adverse effects for maternal and neonatal. 　　【Key words】Natural delivery; Unprotected perineum; Episiotomy会阴侧切是产科最常见的手术, 是为了缩短第二产程, 避免会阴严重撕裂伤等而采用的一种助产手术, 传统的助产理念一般认为若不进行会阴侧切, 则可能导致产妇会阴重度撕裂, 因此目前普遍采取会阴侧切的方法, 虽然能让宝宝尽快降生, 以减少胎儿宫内缺氧、新生儿窒息、损伤及母亲原有疾病病情恶化等情况的出现, 但同时皮下组织、肌肉愈合后要与周围的组织重新生长在一起, 软化到像其他组织一样的程度, 需要几个月的时间。无保护会阴分娩可以不用保护会阴, 使胎头娩出时对阴道产生的压力均匀分布, 没有外界阻力, 不易引起会阴裂伤。改变了传统助产术“一刀切”的现状, 只要胎儿大小适宜, 产妇在助产士的指导下, 适时用力, 无需对会阴进行人工保护, 助产士仅需在胎头娩出时用手轻抵胎儿头部, 控制娩出速度, 通过助产士与产妇的良好沟通、适时指导, 能达到无需侧切、减少并发症的效果。现将本院临床结果报告如下。 　　1资料与方法 　　1. 1一般资料取2013年8~12月间在本院阴道分娩的产妇100例, 分为观察组和对照组各50例, 两组产妇均为单胎、足