余节华（弋阳县中医院 江西 334400）

阴道分娩软产道损伤132例临床分析

余节华*
（弋阳县中医院 江西 334400）

摘 要目的: 探讨经阴道分娩发生软产道损伤类别、分娩方式及它们之间的相互关系。方法: 回顾性分析132例经阴道分娩发生软产道损伤患者的临床资料。结果: 132例患者，会阴阴道裂伤108例（81.82%）, 其中侧切再损伤89例（67.42%）, 未侧切阴道裂伤19例（67.42%）；软产道损伤在妊娠合并高血压疾病、肝功能障碍、急产患者中的发生率高于无合并症者（P＜0.05）；助产术者高于正常产者（P＜0.05）；长产程者高于短产程者（P＜0.05）。结论: 重视产妇发生软产道损伤的高危因素, 及时正确地诊断和处理软产道损伤是降低软产道损伤并发症、提高围产保健的重要内容。

关键词阴道分娩 软产道损伤 发生率

Clinical analysis of 132 cases of vaginal delivery with soft birth canal injury

YU Jiehua*
(Traditional Chinese Medicine Hospital of Yiyang County, Jiangxi 334000, China)

ABSTRACTObjective: To investigate the categories of vaginal delivery with soft birth canal injury, mode of delivery and their relationship. Methods: Clinical data on 132 cases of vaginal delivery with soft birth canal injury were retrospectively analyzed. Results: Among the 132 cases of patients, there were 108 cases of (81.82%) perineal vaginal laceration, in which there were 89 cases (67.42%) of side cut and injury and 19 cases (67.42%) of vaginal laceration without side cut. Incidence of soft birth canal injury was significantly higher in patients with pregnancy induced hypertension complicated with liver dysfunction, liver dysfunction and emergency childbirth, midwifery and longer labor than in ones without complications, normal childbirth and shorter labor (P < 0.05), respectively. Conclusion: Great attention should be paid to the importance of risk factors of maternal related to soft birth canal injury, and its timely and correct diagnosis and treatment are an important content of reducing the complications and improving perinatal health care.

KEY WORDSvaginal delivery; soft birth canal injury; incidence

阴道分娩软产道损伤是产科分娩时常见的并发症之一, 指子宫下段、宫颈、阴道、盆底及会阴等软组织的损伤, 临床主要表现为出血, 严重者可导致失血、感染等并发症, 甚至造成母体死亡[1]。本文通过分析我院2009 年12月-2012年12月收治的经阴道分娩发生软产道损伤132例患者临床资料, 以总结软产道损伤发生因素和防治方法。

1 资料与方法

1.1 一般资料

我院产科于2009年12月-2012年12月收治住院分娩产妇8 531例，其中剖宫产3 988例（46.75%），阴道分娩4 543例（53.25%）；在阴道分娩中，顺产（包括会阴侧切）3 719例（81.86%），助产术824例（18.14%），其中胎头吸引(胎吸)术328例（7.22%），产钳469例（10.32%），臀牵引27例（0.59%）。阴道分娩中发生软产道损伤132例（2.91%），年龄20~47（26.5±2.5）岁；孕周37~43（39.27±0.48）周；产程2.46~17.98 h，平均9.38 （7.25±2.15）h；新生儿体重2 550~4 500（3 550±128）g；初产妇103例，经产妇29例。

1.2 方法

回顾性分析患者的临床资料, 对经阴道分娩发生软产道损伤发生的部位、原因及分娩方式等因素进行统计。……