经阴道分娩结局与会阴侧切的临床分析

目的研究会阴侧切对经阴道分娩结局的影响,有效降低会阴侧切率,促进自然分娩。方法选取2013年10月至2014年10月在江苏省中西医结合医院行会阴侧切经阴道分娩的产妇200例作为观察组,同期经阴道分娩非会阴侧切产妇200例作为对照组,比较两组产妇分娩后的会阴水肿、疼痛、愈合、感染情况,产后24 h出血量,性生活情况,压力性尿失禁及脏器脱垂等情况。结果对照组产妇出血量(343.94±69.55)m L少于观察组(404.75±89.87)m L(P0.05)。两组第二产程时间、新生儿Apgar评分比较差异均无统计学意义(P0.05)。对照组会阴裂伤多为I度裂伤(159/200),观察组产妇伤口疼痛分级(≥2级82例)明显高于对照组(≥2级17例),两组产妇会阴伤口水肿情况相当,且均出现了盆底功能障碍性疾病的临床表现,但观察组分娩后压力性尿失禁、阴道前后壁脱垂、子宫脱垂发生率较高。结论经阴道非会阴侧切的分娩结局优于会阴侧切经阴道分娩者,低危孕妇不建议会阴侧切经阴道分娩。

Clinical analysis of the vaginal delivery outcome and episiotomy

Objective To research the effect of episiotomy on vaginal delivery outcome , to reduce episiotomy rate and promote natural childbirth .Methods 200 cases of episiotomy vaginal delivery women hospitalized in Integrated Hospital of Traditional Chinese and Western medicine of Jiangsu Province from October 2013 to October 2014 were selected as the observation group , while another 200 cases of natural childbirth women hospitalized at the same time were chosen as the control group .Compared the perineal edema , pain, healing, infection, 24 hours bleeding, sexual life, organ prolapse and stress urinary incontinence of the two groups .Results The amount of bleeding of puerpera in control group (343.94 ±69.55)mL was less than that of the observation group (404.75 ±89.87) mL,and the difference was statistically significant (P<0.05).The differences of the second stage of labor (P=0.24) and neonatal Apgar score ( P=0.56 ) between the two groups were not statistically significant .Most puerpera in control group had the I degree perineal laceration (159/200) .The wound pain rating of observation group was significantly higher than that of the control group .The wound edema of the two groups were almost the same , all the puerpera showed clinical manifestations of pelvic floor dysfunction ( PFD) , but the observation group had higher incidence of stress urinary incontinence , vaginal anterior and posterior wall prolapse and uterine prolapse after childbirth .Conclusion The vaginal birth outcomes of non -episiotomy is superior to episiotomy .The low-risk pregnant women are not recommended of vaginal delivery episiotomy .