评价无保护助产护理对初产妇自然分娩的干预效果

凌鹏飞

【摘 要】 目的：评估对初产妇自然分娩采取无保护助产护理的临床效果。方法：选取本院产科2018年4月至2019年4月收治的分娩初产妇90例，分成两组，对照组（n=42）采取常规助产护理，观察组（n=48）采取无保护助产护理，比较两组产妇会阴损伤情况及分娩结局。结果：两组会阴侧切率、产后尿潴留、会阴疼痛及撕裂发生率比较差异有统计学意义（P<0.05）;两组总产程、产程出血率及新生儿不良情况总发生率比较差异无统计学意义（P>0.05）。结论：无保护助产护理可有效促进初产妇自然分娩。

【关键词】 无保护助产护理;初产妇;自然分娩

Evaluation of intervention effect of unprotected midwifery nursing on natural delivery of primipara

Ling Pengfei

Baise People's Hospital， Baise， Guangxi 533000

[Abstract] Objective：To evaluate the clinical effect of unprotected midwifery nursing for natural delivery of primipara. Methods： 90 primipara admitted to obstetrics in our hospital from April 2018 to April 2019 were divided into two groups. The control group （n=42） was given routine midwifery nursing， and the observation group （n=48） was treated with unprotected midwifery nursing. The perineal injury and delivery outcome of the two groups were compared. Results： There were statistically significant differences in perineal lateral resection rate， postpartum urinary retention， perineal pain and tear between the two groups （P<0.05）， but there was no statistically significant difference in the total process of labor， the bleeding rate during labor and the total incidence of neonatal adverse conditions between the two groups （P>0.05）. Conclusion： Unprotected midwifery nursing can effectively promote the natural delivery of primipara and is worth popularizing.

[Key words]Unprotected midwifery nursing; Primipara; Natural delivery

WHO推薦并提倡采取自然分娩方式，剖宫产多在异常分娩与病理分娩中使用，因此自然分娩对母婴而言意义重大。近年来产科广泛开展产前健康宣教，提高产妇对分娩的科学认知，越来越多的产妇开始倾向于选择自然分娩方式。但自然分娩可能会导致会阴撕裂，而传统助产方式为促进顺利分娩会实行会阴侧切，侧切后切口肌肉愈合时间较长，且易水肿或感染，对产妇恢复产生不利影响。助产士为保护会阴会从会阴开始用外力压迫胎头，阻碍胎头娩出，将胎头对耻骨弓压力向会阴转移，此时会阴扩张不完全便会增加损伤风险;再加之强行为会阴提供保护还会损伤盆底筋膜及皮下深部肌肉，增加远期不良反应如加压性尿失禁及子宫脱垂等发生风险[1]。近年来产科逐渐引入无保护助产护理，主张尽量不实行会阴侧切，分娩期间胎头娩出速度仅用手来控制，不会外力施压。研究结果[2-3]表明该护理模式可减少产妇会阴撕裂风险及出血量。……