國際產(chǎn)科服務(wù)模式對(duì)初產(chǎn)婦會(huì)陰側(cè)切率的影響

羅玲+張小宴+湯桂華+孔月香

[摘要]目的 探討國際產(chǎn)科服務(wù)模式對(duì)初產(chǎn)婦會(huì)陰側(cè)切率的影響。方法 選取2016年2～7月我院收治的初產(chǎn)婦230例，分為對(duì)照組（2～4月）和觀察組（5～7月），各115例。對(duì)照組采用常規(guī)產(chǎn)科服務(wù)模式，觀察組在常規(guī)模式的基礎(chǔ)上行國際產(chǎn)科服務(wù)模式措施，對(duì)比分析兩組會(huì)陰側(cè)切情況以及護(hù)理總滿意度。結(jié)果 觀察組會(huì)陰側(cè)切率為26.08%，對(duì)照組為69.57%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組護(hù)理總滿意度為98.26%，明顯高于對(duì)照組的85.21%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。影響會(huì)陰側(cè)切因素包括年輕助產(chǎn)士技術(shù)欠嫻熟、高危產(chǎn)婦評(píng)估不足、產(chǎn)婦缺乏分娩知識(shí)、醫(yī)療干預(yù)、臨床監(jiān)督力度不足及醫(yī)患關(guān)系緊張。分娩后，觀察組會(huì)陰血腫及會(huì)陰水腫率均明顯低于對(duì)照組（P<0.05）。結(jié)論 國際產(chǎn)科服務(wù)模式應(yīng)用于初產(chǎn)婦后，明顯降低會(huì)陰側(cè)切率，并大大提高產(chǎn)婦及其家屬的護(hù)理滿意度。

[關(guān)鍵詞]國際產(chǎn)科服務(wù)模式；初產(chǎn)婦；會(huì)陰側(cè)切率

[中圖分類號(hào)] R713.2+3 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 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

目前國內(nèi)產(chǎn)科在臨床上的會(huì)陰側(cè)切率呈不斷上升趨勢(shì)，以至于部分三級(jí)醫(yī)院的側(cè)切率高達(dá)95%以上[1-2]。會(huì)陰側(cè)切有縮短產(chǎn)婦的產(chǎn)程優(yōu)點(diǎn)，然而也存在如出血多、愈合較慢、感染率高以及產(chǎn)后會(huì)陰疼痛、對(duì)產(chǎn)婦盆底肌群的損傷較大等缺點(diǎn)。產(chǎn)婦在知道分娩中需行會(huì)陰側(cè)切的情況下，其不安的情緒會(huì)影響整個(gè)分娩過程，造成部分不良情況并大大降低護(hù)理滿意度[3-4]，因此，為降低初產(chǎn)婦的側(cè)切率以及提高產(chǎn)婦對(duì)護(hù)理人員的滿意度，選取我院初產(chǎn)婦為研究對(duì)象，取得較好的臨床效果，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

選取2016年2～7月我院收治的初產(chǎn)婦230例，按收治月份分為對(duì)照組（2～4月）和觀察組（5～7月），各115例。對(duì)照組年齡22～30歲，平均（25.68±2.12）歲；觀察組年齡21～29歲，平均（25.75±2.09）歲，兩組患者一般資料比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。