阴道分娩单纯会阴条件评估表的设计和临床效果评价

目的 探讨阴道分娩单纯会阴条件评估表的设计和应用。利于助产士对产妇会阴条件同质化评估,降低会阴切开率。方法 通过查阅相关文献、品管圈工具找出会阴切开相关问题,对932例阴道分娩产妇会阴情况进行查检、相关产科医师及助产专家访谈,自行设计出阴道分娩单纯会阴条件评估表。单纯会阴条件评估表通过信效度效验(α=0.7964)后在临床中采取非随机对照研究方法,将研究对象分为两组,试验组:用单纯会阴条件评估表评估产妇会阴条件746例;对照组:传统主观判断法评估会阴条件673例。比较两组产妇会阴裂伤程度、侧切率和新生儿窒息率。结果 试验组会阴侧切率低于对照组,差异有统计学意义(P＜0.01);试验组会阴Ⅱ度裂伤率略高于对照组,差异无统计学意义(P＞0.05),且试验组会阴Ⅰ度裂伤及完整率均高于对照组,差异有统计学意义(P＜0.05);两组新生儿窒息比较无统计学差异(P＞0.05)。评估表有效降低了会阴条件差和合并症的会阴侧切率,单纯会阴条件评估表易于低年资的助产士掌握,能有效降低侧切率,且差异均具有统计学意义(P＜0.05)。结论 单纯会阴条件评估表操作方便简单、安全、可行,可有效降低侧切率,不增加会阴严重裂伤,减轻产妇损伤,而且不增加新生儿产伤,值得临床推广应用。

The design and clinical application of an evaluation form forsimple perineal condition for vaginal delivery

Objective To investigate the design and application of a simple perineal condition assessment form for vaginal delivery.Contribute to the midwife′s assessment of the homogenization of maternal perineal conditions and reduce the rate of perineal incision.Methods By consulting relevant literature and quality control circle tools to find out the problems related to perineal incision,932 cases of vaginal delivery maternal perineum were examined,interviewed by relevant obstetricians and midwifery experts,and a simple perineal condition evaluation form for vaginal delivery was designed.The simple perineal condition evaluation form was divided into two groups by non-randomized controlled study in the clinical after the reliability and validity test (α=0.7964).The test group: 464 cases of maternal perineal condition were evaluated by simple perineal condition evaluation form;the control group: Traditional subjective judgment method evaluated 673 cases of perineal conditions.The degree of perineal laceration,side cut rate and neonatal asphyxia rate were compared between the two groups.Results The perineal rate was lower in the experimental group than in the control group,and the difference was statistically significant(P＜0.01).The rate of perineal II degree laceration in the experimental group was slightly higher than that in the control group,and the difference was not statistically significant(P＞0.05).The degree of perineal laceration and integrity of the experimental group were higher than that of the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in neonatal asphyxia between the two groups(P＞0.05).The evaluation form effectively reduced the perineal rate of the perineal condition and comorbidity.The simple perineal condition evaluation form is easy for the midwife to master,and can effectively reduce the rate of side cut,and the difference is statistically significant(P＜0.05).Conclusion The simple perineal condition evaluation table is convenient,simple,safe and feasible.It can effectively reduce the rate of side cut,increase the severe laceration of the perineum,reduce the maternal injury,and not increase the birth injury of the newborn.It is worthy of clinical application.