目的 探讨持续硬膜外分娩镇痛联合无保护会阴接生技术在初产妇中的临床应用价值.方法 选择2012年1月至2016年6月本院收治经阴道分娩初产妇80例,按照随机数字法分为两组,各40例,对照组所有入组者均实施经阴道分娩,并行无保护会阴接生技术,观察组则在对照组基础上联用持续硬膜外镇痛,比较两组干预不同时间点疼痛程度、产后恢复正常性生活时间、性生活时性唤起时间以及每月性生活次数,并统计两组分娩过程中会阴裂伤情况.结果 观察组第二产程、产后24 h及出院时,入组者其疼痛视觉模拟评分均显著低于对照组(均P＜ 0.05),观察组会阴完整比例显著高于对照组(P＜0.05),会阴裂伤比例显著低于对照组(P＜0.05),观察组生产后恢复正常性生活时间显著早于对照组(P＜0.05),性生活时性唤起时间显著快于对照组(P＜0.05),每月性生活次数显著多于对照组(P＜0.05).结论 持续硬膜外分娩镇痛联合无保护会阴接生技术能有效减少初产妇分娩过程中疼痛程度,降低会阴裂伤率,提高术后性生活质量.%Objective To study the clinical value of continuous epidural analgesia combined with unprotected perineum delivery in primipara.Methods From January 2012 to June 2016,80 primiparae undergoing transvaginal delivery were enrolled in this study and were randomly divided into a control group and an observation group,40 for each group.The control group underwent vaginal delivery and unprotected perineum delivery;in addition,the observation group took continuous epidural analgesia.The pain at different time points,time for sexual activity,sexual arousal time,and monthly sex life frequency were compared between these two groups.The incidences of perineal laceration during delivery in both groups were calculated.Results During the second stage of labor,24 hours after delivery,and when discharge,the pain visual analogue scores of the observation group were significantly lower than those of the control group (all P ＜ 0.05).The proportion of complete perineum was significantly higher and the proportion of perineal laceration was significantly lower in the observation group than in the control group (both P ＜ 0.05).The time for sexual life returning to normal and sexual arousal time were shorter and monthly sex life frequency was higher in the observation group than in the control group (all P ＜ 0.05).Conclusions Continuous epidural analgesia combined with unprotected perineum delivery in primiparae can effectively relieve their pain during delivery,reduce perineal laceration and lateral rate,and improve postoperative quality of life.
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