帕累托法聯合品管圈活動在順產產婦會陰損傷預防與修復價值

宮睿

【摘要】 目的：探討順產產婦采用帕累托法聯合品管圈活動，對產婦會陰損傷的預防和修復的臨床價值。方法：選取本院2016年4月-2017年3月入住本院的順產產婦180例作為主要觀察對象，按照隨機數字表法分為護理組（n=90）與對照組（n=90）。護理組采用帕累托法聯合品管圈活動，對照組采用常規產科護理。比較兩組會陰損傷程度、會陰側切率、會陰疼痛情況及盆底功能。結果：兩組會陰裂傷程度比較，差異無統計學意義（P>0.05）;護理組側切率及會陰損傷發生率均明顯低于對照組（P<0.05）;護理組會陰疼痛程度及NRS評分均明顯低于對照組（P<0.05）;護理組產后3個月的盆底肌Ⅰ類及Ⅱ類肌力均明顯高于對照組（P<0.05）。結論：順產產婦采用帕累托法聯合品管圈活動，能夠降低產婦會陰側切及損傷發生率，減輕產婦產后會陰疼痛程度，且有助于產婦產后盆底肌功能恢復。

【關鍵詞】 帕累托法; 品管圈活動; 順產; 會陰損傷

The Value of Pareto Method Combined with Quality Control Circle Activity in the Prevention and Repair of Perineal Injury in Parturients with Natural Labour/GONG Rui.//Medical Innovation of China，2019，16（22）：-109

【Abstract】 Objective：To explore the clinical value of Pareto method combined with quality control circle in the prevention and repair of perineal injury in parturient with natural labour.Method：180 cases of parturient with natural labour admitted to our hospital from April 2016 to March 2017 were selected as the main observation objects.They were divided into nursing group（n=90）and control group（n= 90）according to random number table method.The nursing group was given Pareto method combined with quality control circle activity，and the control group was given routine obstetric nursing.The degree of perineal injury，perineal resection rate，perineal pain and pelvic floor function were compared between the two groups.Result：There was no significant difference in the degree of perineal laceration between the two groups（P>0.05）.The rate of side cut and incidence of perineum injury in the nursing group were significantly lower than those in the control group（P<0.05）.The degree of perineum pain and NRS score in the nursing group were significantly lower than those in the control group （P<0.05），and the pelvic floor type Ⅰ and Ⅱ muscle strength in the nursing group were significantly higher than those in the control group（P<0.05）.Conclusion：Pareto method combined with quality control circle activity can reduce the incidence of perineal cut and injury，alleviate perineum pain and contribute to the recovery of pelvic floor muscle function.

【Key words】 Pareto method; Quality control circle activity; Natural Labour; Perineum injury

First-authors address：Jiamusi Maternal and Child Health Hospital，Jiamusi 154000，China

doi：10.3969/j.issn.1674-4985.2019.22.028

女性分娩是一個復雜的生理過程[1-2]。尤其是隨著人們的生活水平提高，胎兒的營養水平改善，順產產婦的側切率也逐年上升，會陰側切雖然能夠降低會陰裂傷的發生風險，但會陰側切仍會造成產婦產后恢復時間延長及盆底功能異常問題[3-4]。帕累托法也被稱為“二八定律”，其中涵蓋內部控制法則，被運用于產科管理尚在萌芽階段[5]。而品管圈管理已被證實，適用于產科護理[6-7]。但對產婦會陰損傷的觀察研究卻極為少見。因此，本研究將帕累托法和品管圈活動相結合，并采用臨床對照研究方式明確順產產婦會陰損傷的預防及修復方面的價值，現報道如下。