國際產科服務模式對初產婦會陰側切率的影響

羅玲+張小宴+湯桂華+孔月香

[摘要]目的 探討國際產科服務模式對初產婦會陰側切率的影響。方法 選取2016年2～7月我院收治的初產婦230例，分為對照組（2～4月）和觀察組（5～7月），各115例。對照組采用常規產科服務模式，觀察組在常規模式的基礎上行國際產科服務模式措施，對比分析兩組會陰側切情況以及護理總滿意度。結果 觀察組會陰側切率為26.08%，對照組為69.57%，差異有統計學意義（P<0.05）；觀察組護理總滿意度為98.26%，明顯高于對照組的85.21%，差異有統計學意義（P<0.05）。影響會陰側切因素包括年輕助產士技術欠嫻熟、高危產婦評估不足、產婦缺乏分娩知識、醫療干預、臨床監督力度不足及醫患關系緊張。分娩后，觀察組會陰血腫及會陰水腫率均明顯低于對照組（P<0.05）。結論 國際產科服務模式應用于初產婦后，明顯降低會陰側切率，并大大提高產婦及其家屬的護理滿意度。

[關鍵詞]國際產科服務模式；初產婦；會陰側切率

[中圖分類號] R713.2+3 [文獻標識碼] A [文章編號] 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

目前國內產科在臨床上的會陰側切率呈不斷上升趨勢，以至于部分三級醫院的側切率高達95%以上[1-2]。會陰側切有縮短產婦的產程優點，然而也存在如出血多、愈合較慢、感染率高以及產后會陰疼痛、對產婦盆底肌群的損傷較大等缺點。產婦在知道分娩中需行會陰側切的情況下，其不安的情緒會影響整個分娩過程，造成部分不良情況并大大降低護理滿意度[3-4]，因此，為降低初產婦的側切率以及提高產婦對護理人員的滿意度，選取我院初產婦為研究對象，取得較好的臨床效果，現報道如下。

1資料與方法

1.1一般資料

選取2016年2～7月我院收治的初產婦230例，按收治月份分為對照組（2～4月）和觀察組（5～7月），各115例。對照組年齡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，差異無統計學意義（P>0.05），具有可比性。