鱼尾尺测量评估法对降低初产妇会阴损伤的效果观察

目的 探讨鱼尾尺测量评估法对降低初产妇会阴损伤的应用效果。方法 选取2018年7月—2019年6月在中山市博爱医院住院分娩孕足月头位初产妇,无阴道分娩禁忌证,适合阴道分娩的400例,按随机数字表分将入选产妇分为对照组和观察组,每组各200例。对照组采用传统会阴保护方式接产,观察组接产前应用鱼尾尺测量会阴体和阴道口前后径长度的评估法实施会阴保护方式。观察2组初产妇分娩后会阴情况。结果 观察组会阴完整35例,会阴侧切40例,会阴Ⅰ裂伤55例,会阴Ⅱ裂伤70例,会阴III或以上裂伤0例;对照组会阴完整10例,会阴Ⅰ裂伤30例,会阴Ⅱ裂伤99例,会阴III裂伤1例。观察组初产妇会阴损伤情况低于对照组,差异有统计学意义（P<0.05）。结论 应用鱼尾尺测量长度的综合评估法能准确、量化评估,指导产房助产士适时采取会阴保护干预措施,减少不必要的会阴侧切,降低产妇在分娩过程中会阴裂伤的发生。

Effect of Comprehensive Assessment with "Fishtail Ruler" on Reducing Perineal Injury

Objective To explore the application effect of comprehensive assessment with "fishtail ruler" on reducing perineal injury. Methods A total of 400 cases of patients with full-term pregnancy, presenting no contraindications of vaginal delivery from July 2018 to June 2019 in Zhongshan Boai Hospital were divided into control group and observation group, with 200 cases in each group. In the control group, traditional perineal protection measures were implemented while in the observation group, comprehensive assessment with "fishtail ruler" was performed to measure the anterior and posterior diameter of perineum body and vaginal opening before perineal protection measures were implemented. Results There were 35 cases without perineal tear, 40 of lateral episiotomy, 55 of first-degree tear, 70 of second-degree tear and no case of third-degree or fourth-degree tear in the observation group and in the control group, there were 10 cases without perineal tear, 30 cases of first-degree tear, 99 of second-degree tear and 1 of third-degree tear. The case of lateral perineal incisions and deep perineal laceration in the observation group was significantly less than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Comprehensive assessment with "Fishtail Ruler" is accurate and quantitative, which guides the midwife to take perineal protection measures timely, thus to reduce unnecessary episiotomy and perineal laceration during childbirth.