会阴弹性护理配合改良会阴侧切术对初产妇疼痛及分娩的影响

目的 探讨会阴弹性护理配合改良会阴侧切术对初产妇疼痛及分娩的影响.方法 于我院产科住院分娩的初产妇200例,按随机数字表法分为观察组与对照组各100例.观察组行改良会阴侧切术(25°～30°)+孕期会阴弹性护理,对照组行传统会阴切开术(45°).结果 观察组初产妇术后疼痛程度( Ⅰ级70％、Ⅱ级24％、Ⅲ级4％、Ⅳ级2％)明显轻于对照组(Ⅰ级21％、Ⅱ级19％、Ⅲ级50％、Ⅳ级10％),差异有显著性(P＜0.05).观察组会阴伤口 Ⅰ期、Ⅱ期愈合率(97％、3％)高于对照组(91％、8％),但差异无显著性(P＞0.05).观察组的新生儿体重和新生儿窒息发生率[(2874.46±313.44)g,0％]与对照组[(3235.15±311.03)g,4％]相比差异有显著性(P＜0.05).结论 会阴弹性护理配合改良会阴侧切术不仅可以增加肌肉组织的柔韧性和弹性,而且损伤小、缝合快、产妇痛苦减轻、会阴及盆底组织严重裂伤减少,提出会阴弹性护理配合改良会阴侧切术应用于临床有现实意义.

Influence of perineal elastic nursing matching improved episiotomy on primipara's pain and parturition

Objective To discuss the influence of perineal elastic nursing matching improved episiotomy on primipara＇ s pain and parturition. Methods 200 primiparas in our hospital were collected, according with the method of random digits table, divided randomly into obselvation group and control group with 100 cases for each group, we compared the observation group which accepted the perineal elastic nursing matching improved episiotomy （angle of 25-30） with the control group which accepted traditional episiotomy （angle of 45）.Results In the observation group, the degree of postop- erative pain（ level one to four was 70%, 24%, 4% and 2% respectively ）was significantly weaker than that of the control group（ level one to four was 21%, 19%, 50% and 10% respectively ）, and the difference was statistically significant （the rate of healing by first intention and second intention was 97%, 3% to 91%, 8%, P〈0.05）.The perineal wound healing rate had no statistical difference in two groups （P〉0.05）. The neonatal birth weight（ 2874.46 e 313.44 ） g to （3235.15 -＋ 31 I. 03 ）g and neonatal asphyxia rate （ 0% to 4% ） had statistical difference in two groups （P〈0.05）. Conclusions Perineal elastic nursing matching improved episiotomy can not only increase muscle＇ s flexibility and elasticity, but also has less injury, quick suture, and reduce primipara＇ s pain, perineal and pelvic floor tissues in severe laceration of perineum. Perineal elastic nursing matching small angle episiotomy has practical significance in clinical application.