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闵辉.改良式助产手法在低危初产妇自然分娩中的临床应用[J].上海护理,2016,16(1):
改良式助产手法在低危初产妇自然分娩中的临床应用
DOI：
中文关键词:  初产妇  改良式助产  会阴侧切率
英文关键词:primipara  intrapartum nursing management  lateral episiotomy rate
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作者单位E-mail
闵辉* 复旦大学附属妇产科医院 happymaomao.minni@163.com 
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中文摘要:
      目的 探讨在低危初产妇自然分娩中应用改良式助产手法以降低会阴侧切率的临床效果观察。 方法 回顾分析自2012年10~12月运用传统方法行自然阴道分娩的592例初产妇的临床资料，作为对照组；并以2013年10月~12月经改良式助产手法应用后行自然阴道分娩的541例初产妇的临床资料作为观察组。对两组产妇的会阴侧切情况、产后出血、第二产程、新生儿窒息情况等进行比较分析。 结果 对照组592例初产妇中，会阴侧切者为584例，会阴侧切率98.6%；观察组541例初产妇中，会阴侧切者为320例，会阴侧切率为59.1%，两组比较，差异有统计学意义（P<0.001），两组产妇的产后出血、第二产程延长、会阴III度撕裂、新生儿窒息差异无统计学意义（P>0.05）。结论 改良式助产手法方法能显著降低初产妇的会阴侧切率，最大程度的维护了会阴的完整性，同时无明显的不良分娩结局，有效地提高了助产质量。
英文摘要:
      Objective To investigate the effects of improved midwifery skills on reducing episiotomy rate of low-risk primiparas in childbirth.Methods A retrospective study was conducted including 592 primiparas with traditional vaginal delivery in our hospital from October to December 2012 were recruited as the control group，and 541 primiparas with vaginal delivery who received improved midwifery skills in our hospital from October to December 2013 were recruited as the observational group. The situation of episiotomy，the postpartum hemorrhage, the second stage of labor and neonatal asphyxia are compared.Results A total of 584 out of 592(98.6%)primiparas underwent episiotomy in the control group,while 320 out of 541(59.1%) in the observational group underwent episiotomy.The difference was significant(P<0.001).There was no significance between the two group on postpartum hemorrhage,prolonged second stage of labor,III degree of perineal laceration and neonatal asphyxia(P>0.05).Conclusion Improved midwifery skills for the nursing management can significantly reduce the episiotomy rate of primiparas,maintaining the greatest integrity of the perineum,no adverse effects on maternal and neonatal morbidities and also improving the quality of midwifery effectively.
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