张敏 王文华 何丽艳

[摘要]目的 研究單手保护会阴接生法在初产妇自然分娩中的应用效果。方法 选取2016年6月～2018年5月在我院进行自然分娩的200例初产妇的临床资料进行回顾性分析，根据接生方式的不同，将2016年6月～2017年5月采用传统会阴保护措施接生的100例初产妇作为对照组，将2017年6月～2018年5月采用单手保护会阴接生法的100例初产妇作为观察组。比较两组初产妇的阴道出血量、产程时间、会阴侧切率、产后会阴水肿和疼痛程度、会阴裂伤程度、新生儿情况、产妇满意度、住院时间。结果 两组初产妇的阴道出血量比较，差异无统计学意义（P>0.05）;观察组初产妇的第二产程时间长于对照组，住院时间短于对照组，差异有统计学意义（P<0.05）;观察组产妇的会阴侧切率、产后会阴水肿发生率均低于对照组，差异有统计学意义（P<0.05）;观察组产妇的会阴裂伤、会阴疼痛程度均优于对照组，差异有统计学意义（P<0.05）;观察组新生儿的阿氏评分高于对照组，差异有统计学意义（P<0.05）;观察组初产妇的总满意度高于对照组，差异有统计学意义（P<0.05）。结论 在初产妇自然分娩中采用单手保护会阴接生法有助于降低会阴侧切率，减轻会阴裂伤程度和产后会阴疼痛程度，其效果令人满意，临床应用价值高。

[关键词]初产妇;自然分娩;单手保护会阴接生法

[中图分类号] R714.3          [文献标识码] A          [文章编号] 1674-4721（2019）9（c）-0247-03

[Abstract] Objective To study the effect of one-handed perineal delivery method in natural delivery of primipara. Methods The clinical data of 200 primipara who gave birth naturally in our hospital from June 2016 to May 2018 were retrospectively analyzed. They were divided into two groups according to the different ways of delivery. 100 primipara who received traditional perineal protection measures from June 2016 to May 2017 were taken as control group， and 100 primipara who received one-handed perineal protection method from June 2017 to May 2018 were taken as observation group. The amount of vaginal bleeding， the time of delivery， the rate of lateral perineal excision， the degree of perineal edema and pain， the degree of perineal laceration， the condition of neonates， satisfaction and hospitalization time were compared between the two groups. Results There was no significant difference in the amount of vaginal bleeding between the two groups （P>0.05）. The second stage of labor in the observation group was longer than that in the control group， and the hospital stay was shorter than that in the control group， the differences were statistically significant （P<0.05）. The incidence of perineal cut and postpartum perineal edema in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. The degree of perineal laceration and perineal pain in the observation group were better than those in the control group， with statistically significant （P<0.05）. The Apgar score of the newborns in the observation group was higher than that of the control group， the difference was statistically significant （P<0.05）. The total satisfaction of the primipara in the observation group was higher than that of the control group， and the difference was statistically significant （P<0.05）. Conclusion Single-handed perineal with protection during natural delivery of primipara is helpful to reduce the rate of lateral perineal incision， the degree of perineal laceration and the degree of postpartum perineal pain. The effect is satisfactory and the clinical application value is high.

[Key words] Primipara; Natural delivery; One-handed perineum delivery method

传统的助产术多半会进行人工会阴侧切[1]，在一定程度上可防止产妇生产时出现会阴撕裂的情况，但是留下的切口会影响产后恢复。我国传统助产术的会阴侧切率在80%以上[2]，与会阴侧切术的指征相违背，目前产科面临着如何降低高会阴侧切率、减轻产妇疼痛的问题。本研究选取于我院进行自然分娩的200例初产妇作为研究对象，旨在探讨单手保护会阴接生法在初产妇自然分娩中的应用效果，现报道如下。

1资料与方法

1.1一般资料

选取2016年6月～2018年5月在我院进行自然分娩的200例初产妇的临床资料进行回顾性分析，根据接生方式的不同分为两组，将2016年6月～2017年5月采用传统会阴保护措施接生的100例初产妇作为对照组，将2017年6月～2018年5月采用单手保护会阴接生法的100例初产妇作为观察组。对照……