郑 后，顾凯芬，余佩红

(舟山医院，浙江 舟山 316004)

·临床护理·

阴部管内神经阻滞麻醉配合无保护会阴接生的效果观察

郑 后，顾凯芬，余佩红

(舟山医院，浙江 舟山 316004)

目的：探讨阴部管内神经阻滞麻醉配合无保护会阴接生的效果。方法回顾性分析怀孕37～42周经阴道头位分娩的初产妇80例，按照是否采用双侧阴部管内神经阻滞麻醉分成麻醉组和对照组，比较2组产妇的疼痛程度、会阴裂伤严重程度。结果麻醉组的疼痛程度明显低于对照组，麻醉组的会阴完整率高于对照组，差异均有统计学意义(P<0.05)。结论阴部管内神经阻滞麻醉能有效地松驰会阴组织肌肉，减轻产妇分娩时及缝合时的疼痛，减少会阴部的裂伤，提高无保护会阴接生的成功率，促进自然分娩。

神经阻滞麻醉；阴部管；无保护会阴接生

Abstract: [Objective]To investigate the effect of pudendal canal nerve block anesthesia without perineum midwifery protection. [Method]80 cases of transvaginal head delivery who were pregnant within 37-42 weeks were retrospectively analyzed in our study. According to whether to adopt to the bilateral pudendal tube nerve block anesthesia, the patients were divided into two groups. The maternal level of pain severity and perineal laceration were analyzed between the two groups. [Result] the pain degree of primiparas from observation group was obviously lower than that of the control group. The perineum integrity rate is higher than that of the control group. The difference had statistical significance (P<0.05). [Conclusion]The pudendal canal nerve block anesthesia can effectively relax perineal muscles, reduce puerpera’s pain during the process of childbirth and wound closure, reduce the perineal laceration, improve the success rate of the unprotected perineum midwifery and promote natural childbirth.

Keywords: nerve block anesthesia; pudendal canal; no protection perineum midwifery

阴部神经阻滞麻醉在分娩过程中已广泛使用，常规的坐骨棘处神经阻滞麻醉由于其进针位置较深，操作过程中易损伤阴部内动、静脉而造成出血，影响麻醉效果，且对麻醉者的技术要求较高、并发症多[1]。无保护会阴接生是指不保护会阴，按照分娩的自然过程，助产士单手控制胎头娩出的速度，帮助产妇在宫缩间歇期缓缓娩出胎儿[2]。为了更好地减少阴道分娩过程中的会阴裂伤，减轻产妇疼痛，我院产科在2015年1-8月对46例初产妇在第二产程中实行双侧阴部管内神经阻滞麻醉配合无保护会阴接生，取得了较好的临床效果，现报告如下。

1资料与方法

1.1 临床资料

选取2015年1-8月我院产科收住的顺产初产妇100例。纳入标准：(1)怀孕37～42周、单胎、头位；(2)无孕期并发症、妊娠合并症；(3)经骨盆测量、B超检查等无顺产禁忌症，且阴道分娩愿望强烈者；(4)排除会阴有炎症、糜烂、溃疡、疤痕及利多卡因过敏者；……