国际产科服务模式对初产妇会阴侧切率的影响

罗玲+张小宴+汤桂华+孔月香

[摘要]目的 探讨国际产科服务模式对初产妇会阴侧切率的影响。方法 选取2016年2～7月我院收治的初产妇230例，分为对照组（2～4月）和观察组（5～7月），各115例。对照组采用常规产科服务模式，观察组在常规模式的基础上行国际产科服务模式措施，对比分析两组会阴侧切情况以及护理总满意度。结果 观察组会阴侧切率为26.08%，对照组为69.57%，差异有统计学意义（P<0.05）；观察组护理总满意度为98.26%，明显高于对照组的85.21%，差异有统计学意义（P<0.05）。影响会阴侧切因素包括年轻助产士技术欠娴熟、高危产妇评估不足、产妇缺乏分娩知识、医疗干预、临床监督力度不足及医患关系紧张。分娩后，观察组会阴血肿及会阴水肿率均明显低于对照组（P<0.05）。结论 国际产科服务模式应用于初产妇后，明显降低会阴侧切率，并大大提高产妇及其家属的护理满意度。

[关键词]国际产科服务模式；初产妇；会阴侧切率

[中图分类号] R713.2+3 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0182-03

[Abstract]Objective To explore the influence of international obstetric service model on primiparas′ lateral episiotomy rate.Methods 230 cases of primiparas who were treated in our hospital from February to July 2016 were selected and divided into control group （from February to April） and observation group （from May to July），115 cases in each group.The control group was treated with routine obstetric service model，while，the observation group was treated with the international obstetric service model on the basis of the conventional mode.The lateral episiotomy rate and nursing satisfaction degree of two groups were compared and analyzed.Results The lateral episiotomy rate of observation group was 26.08%，the control group was 69.57%，with significant difference （P<0.05）；the total nursing satisfaction degree of observation group was 98.26%，significantly higher than that of control group of 85.21%，with significant difference（P<0.05）.The factors that affected the lateral episiotomy included the lack of skilled young midwives，inadequate assessment of high-risk puerperas，puerperas′ lack of maternal knowledge，medical intervention，lack of clinical supervision and the tension between doctors and patients.After delivery，the rate of perineal hematoma and perineal edema in observation group were significantly lower than those of control group（P<0.05）.Conclusion Application of international obstetric service model in primiparas significantly reduces the rate of episiotomyand greatly improves the satisfaction degree of puerperas and their families.

[Key words]International obstetric service model；Primipara；Lateralepisiotomy rate

目前國内产科在临床上的会阴侧切率呈不断上升趋势，以至于部分三级医院的侧切率高达95%以上[1-2]。会阴侧切有缩短产妇的产程优点，然而也存在如出血多、愈合较慢、感染率高以及产后会阴疼痛、对产妇盆底肌群的损伤较大等缺点。产妇在知道分娩中需行会阴侧切的情况下，其不安的情绪会影响整个分娩过程，造成部分不良情况并大大降低护理满意度[3-4]，因此，为降低初产妇的侧切率以及提高产妇对护理人员的满意度，选取我院初产妇为研究对象，取得较好的临床效果，现报道如下。

1资料与方法

1.1一般资料

选取2016年2～7月我院收治的初产妇230例，按收治月份分为对照组（2～4月）和观察组（5～7月），各115例。对照组年龄22～30岁，平均（25.68±2.12）岁；观察组年龄21～29岁，平均（25.75±2.09）岁，两组患者一般资料比较，差异无统计学意义（P>0.05），具有可比性。