无保护助产护理在促进初产妇自然分娩中应用观察.doc

无保护助产护理在促进初产妇自然分娩中应用观察 　　[摘要]目的 探讨无保护助产护理在促进初产妇自然分娩中的应用效果。方法 选取2015年5月～2017年5月我院收治的自然分娩148例初产妇作为研究对象，采用随机数字表法分为研究组和对照组，每组各74例。对照组产妇给予常规会阴保护助产，研究组产妇则给予无保护助产护理，观察比较两组产妇的会阴侧切、裂伤、疼痛情况以及产后出血等并发症和新生儿窒息的发生情况。结果 研究组产妇会阴侧切率（27.0%）显著低于对照组（75.7%），会阴裂伤及会阴疼痛程度均明显低于对照组，差异均有统计学意义（P0.05）。结论 应用无保护助产护理在产妇分娩时可有效降低会阴侧切率，减轻会阴裂伤和疼痛程度，且能够降低产后并发症的发生率，对于自然分娩具有促进作用，值得临床进一步推广应用。 　　[关键词]无保护助产护理；初产妇；自然分娩；会阴损伤 　　[中图分类号] R473 [文献标识码] A [文章编号] 1674-4721（2017）12（a）-0192-03 　　[Abstract]Objective To explore the application effect of unprotected midwifery care in promoting natural childbirth of primipara.Methods From May 2015 to May 2017，148 cases of primipara with natural childbirth in our hospital were selected as the research object.Using random number table method，they were divided into the study group and the control group，each group of 74 cases of maternal.The control group was given routine perineal protection midwifery，while the study group was given unprotected midwifery care.The episiotomy，laceration，pain，postpartum hemorrhage，complications and neonatal asphyxia were observed and compared between the two groups.Results The episiotomy rate of the study group （27.0%） was significantly lower than that of the control group （75.7%），and the perineal laceration and perineal pain degree were significantly lower than those of the control group，the differences were statistically significant（P0.05）.Conclusion Application of no protection in maternal childbirth midwifery care can effectively reduce episiotomy rate，reduce perineal laceration and pain，and can reduce the incidence of postpartum complications，can promote the natural childbirth，it is worthy of further clinical application. 　　[Key words]Unprotected midwifery nursing；Primipara；Spontaneous delivery；Perineal injury 　　随着临床对自然分娩的提倡和相关健康知识的普及，人们关于剖宫产的观念也在逐渐地发生变化[1]。现在，越来越多的产妇倾向于选择自然分娩的方式。在自然分娩中，为了避免产妇会阴严重撕裂，传统的助产方式常对产?D实施会阴侧切，在侧切后，切口肌肉需要很长时间才能愈合，且切口容易发生水肿甚至感染，不利于产妇产后恢复[2-3]。另外助产师会在胎位胎头着冠时用手托住肛门或会阴的方式行会阴保护，以减轻会阴裂伤。这种保护方式需要把握时机，如果强行保护可能反而使会阴不能