摘要
目的探讨医联体同质化管理对无保护会阴接生的应用效果及对会阴侧切率与中转剖宫产率的影响。方法选择与我院建立医联体关系的基层医院2024年1月~6月收治的400例无保护会阴接生产妇,分为观察组与对照组,各200例。对照组患者实施常规管理,观察组患者实施医联体同质化管理。对比两组产妇分娩结局、产程时间、疼痛程度及分娩控制量、围产期舒适度、不良事件发生率及产妇满意度情况。结果观察组的会阴侧切率、中转剖宫产率均低于对照组,观察组自然阴道分娩率高于对照组(P<0.05);观察组第一产程、第二产程、第三产程时间均明显短于对照组(P<0.05);观察组第一产程、第二产程、第三产程的视觉模拟量表(VAS)评分均低于对照组,观察组第一产程、第二产程、第三产程的分娩控制量表(LAS)评分均高于对照组(P<0.05);观察组轻度不适发生率高于对照组,重度不适发生率低于对照组(P<0.05);观察组宫颈裂伤发生率、会阴裂伤、产后出血、新生儿窒息等不良事件发生率低于对照组(P<0.05);观察组分娩流程、分娩环境、分娩效果、医疗支出、整体评价等产妇满意度评分均高于对照组(P<0.05)。结论医联体同质化管理对无保护会阴接生的应用效果显著,可降低产妇会阴侧切率及中转剖宫产率,缩短产程时间,减轻产程中的疼痛程度,提升分娩控制水平,提高围产期舒适度,降低产后出血、阴道裂伤、新生儿窒息等不良事件发生率,产妇满意度较高。
Objective To explore the application effect of homogeneous management in medical alliances on unprotected perineal delivery and its impact on episiotomy rate and conversion to cesarean section rate.Methods A total of 400 parturients with unprotected perineal delivery,admitted to primary hospitals in medical alliance with our hospital from Jan to Jun 2024,were selected.They were divided into an observation group and a control group,with 200 cases in each group.The control group received routine management,while the observation group was given homogeneous management of the medical alliance.Two groups were compared in terms of delivery outcomes,labor duration,pain intensity,labor control,perinatal comfort,incidence of adverse events,and maternal satisfaction.Results The episiotomy rate and conversion to cesarean section rate in the observation group were both lower than those in the control group,while the spontaneous vaginal delivery rate in the observation group was higher than that in the control group(P<0.05).The duration of the first,second,and third stages of labor in the observation group was significantly shorter than that in the control group(P<0.05).The visual analogue scale(VAS)scores for the first,second,and third stages of labor in the observation group were lower than those in the control group,whereas the labor agentry scale(LAS)scores for the first,second,and third stages of labor in the observation group were higher than those in the control group(P<0.05).The incidence of mild discomfort in the observation group was higher than that in the control group,while the incidence of severe discomfort was lower(P<0.05).The incidence of adverse events,including cervical laceration,perineal laceration,postpartum hemorrhage,and neonatal asphyxia,in the observation group was lower than that in the control group(P<0.05).The maternal satisfaction scores in the observation group for delivery process,delivery environment,delivery effect,medical expenses,and overall evaluation were all higher than those in the control group(P<0.05).Conclusion Homogeneous management of medical alliances shows significant efficacy in unprotected perineal delivery.It can reduce the episiotomy rate and conversion to cesarean section rate in parturients,shorten labor duration,alleviate pain during labor,enhance the level of labor control,improve perinatal comfort,reduce the incidence of adverse events such as postpartum hemorrhage,vaginal laceration,and neonatal asphyxia,and achieve higher maternal satisfaction.
作者
涂业秀
邓新琼
苏艳洁
陈艳华
韦春宏
徐群香
Tu Yexiu;Deng Xinqiong;Su Yanjie;Chen Yanhua;Wei Chunhong;Xu Qunxiang(Department of Obstetrics,Liuzhou Maternal and Child Health Hospital,Liuzhou 545001;Department of Obstetrics,Liuzhou Hospital,Guangzhou Women and Children's Medical Center,Liuzhou 510620)
出处
《中国现代医药杂志》
2025年第8期49-53,共5页
Modern Medicine Journal of China
基金
广西壮族自治区卫生健康委自筹经费科研项目(编号:Z-B20231539)。
关键词
医联体
同质化管理
无保护会阴接生
会阴侧切
产程时间
不良事件
满意度
Medical alliance
Homogeneous management
Unprotected perineal delivery
Episiotomy
Labor duration
Adverse events
Satisfaction
