摘要
目的探讨分娩期会阴切开影响因素,以期为临床降低会阴切开率提供依据。方法 2016年6-12月,整群抽样法选取南京医科大学附属妇产医院产房经阴道分娩产妇5288例为研究对象,以是否行会阴切开为分组标准,1617例会阴切开产妇为病例组,3671例非会阴切开产妇为对照组。对产次、年龄、孕周、羊水性状、产钳术、臀位助产、第二产程时间、高血压、疤痕子宫、产间发热、产力、肩难产、异常胎心变异、胎膜早破、脐带附着部位异常、脐带缠绕、巨大儿、急产、双胎、妊娠糖尿病等20项资料进行单因素和多因素Logistic回归分析。结果单因素分析共筛选出16项相关因素,Logistic回归分析共纳入产次、年龄、孕周、羊水性状、产钳术、臀位助产、第二产程时间、高血压、疤痕子宫、产间发热、产力、肩难产、异常胎心变异共13项会阴切开的影响因素。结论分娩中应及时关注产程变化,动态评估母儿条件,最大程度地降低会阴切开率。
Objective To explore the influencing factors of episiotomy during in delivery,and providing provide scientific basis for decrease of clinical reduction of episiotomy rate in clinical settings.Methods By convenience sampling,5288 cases were selected,and divided into episiotomy group（n=1617）and non-episiotomy group（n=3671）.20 possible Influencing factors of episiotomy included including parity history,age,gestational weeks,character of amniotic fluid,obstetric forceps delivery,assisted breech delivery,second stage of labor,hypertension,scaruterus,fever during delivery,force of labor,shoulder dystocia,abnormal fetal heartbeat,premature rupture of membrane,abnormal attachment of umbilical cord,macrosomia,precipitate labour,twins and gestational diabetes were screened out by univariate and multivariate logistic regression analysis.Results Univariate analysis showed 16 factors related to episiotomy,and 13 influencing factors of episiotomy including production time,age,gestational age,amniotic fluid properties,forceps,assisted breech delivery,the second stage of labor,hypertension,scar uterus,intercatal fever,productivity,shoulder dystocia,abnormal fetal heartbeat were found in the macrosomia,precipitate labour,twins,gestational diabetes mellitus had nothing to do with episiotomy.Llogistic regression analysis showed production time,age,gestational age,amniotic fluid properties,forceps,assisted breech delivery,the second stage of labor,hypertension,scar uterus,intercatal fever,productivity,shoulder dystocia,abnormal fetal heartbeat were the influencing factors of episiotomy.Conclusion The timely attention to the changes of labor in delivery and evaluate evaluation of the condition of mother and fetal fetus can reduce the rate of episiotomy.
作者
朱远
徐桂华
刘婧岩
张爱霞
Zhu Yuan;Xu Guihua;Liu Jingyan;Zhang Aixia(School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China;Delivery Room, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical Univeristy, Nanjing 210000,Jiangsu Province, China;Department of Nurs- ing,Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical Univeristy)
出处
《解放军护理杂志》
CSCD
北大核心
2018年第4期32-36,共5页
Nursing Journal of Chinese People's Liberation Army
基金
江苏省妇幼健康科研项目课题(F201530)
南京市医学科技发展项目(YKK15157)
关键词
分娩期
会阴切开
影响因素
病例对照
stage of labordelivery period
episiotomy
influencing factors
case-control study
