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新型会阴阻滞麻醉(PPB)在第二产程中对会阴松弛及会阴切开率降低的影响:一项随机对照试验

Effect of New Peripudendal Block (PPB) in the Second Stage of Labour on Perineal Relaxation and on the Reduction of Episiotomy Rate: A Randomized Control Trial.

作者信息

Beke Artur

机构信息

Semmelweis University, Department of Obstetrics and Gynaecology, Budapest, Hungary.

出版信息

Obstet Gynecol Int. 2022 Mar 26;2022:9352540. doi: 10.1155/2022/9352540. eCollection 2022.

Abstract

METHODS

In a prospective randomized study, we examined the extent to which the PPB we developed changed the rate of episiotomies, injury rates.

RESULTS

A total of 333 primiparas and 324 multiparas were included in the study. In the case of primiparas, we used the PPD procedure in 133 cases, while in the case of multiparas, we used it in 103 cases. The rate of episiotomy in primiparas was 89/133 (66.9%) with PPD and 181/200 (90.5%) without PPD ( < 0.02). In multiparas, the episiotomy rate was 30/103 (29.1%) with PPD and 140/221 (63.3%) without PPD ( < 0.02). In the case of primiparas, the rate of perineal injury and lesion was 33/133 (24.8%) with PPD, while without PPD it was 12/200 (6.0%). Examining the need for all surgical care (due to episiotomy and/or injury), a total of 103/133 cases of operative surgery were required with PPD (77/4%) while 183/200 cases were required without PPD (91.5%)( < 0.02). In the case of multiparas, the rate of perineal injury and lesion was 11/103 (10.7%) with PPD, while without PPD it was 9/221 (4.1%). In the case of multiparas, a total of 41/103 cases required surgical care with PPD (39.8%), while without PPD, 147/221 cases required surgical care (66.5%)( < 0.02).

CONCLUSION

The PPB is simpler, requires less medication, can be easily mastered, and perineal relaxation can also be observed, reducing the need for an episiotomy.

摘要

方法

在一项前瞻性随机研究中,我们考察了我们所研发的会阴阻滞麻醉(PPB)在何种程度上改变了会阴切开术的发生率及损伤率。

结果

本研究共纳入333例初产妇和324例经产妇。对于初产妇,133例采用了PPD程序,而对于经产妇,103例采用了该程序。采用PPD的初产妇会阴切开率为89/133(66.9%),未采用PPD的为181/200(90.5%)(P<0.02)。对于经产妇,采用PPD的会阴切开率为30/103(29.1%),未采用PPD的为140/221(63.3%)(P<0.02)。对于初产妇,采用PPD时会阴损伤和裂伤率为33/133(24.8%),未采用PPD时为12/200(6.0%)。考察所有手术护理需求(因会阴切开术和/或损伤),采用PPD时共103/133例需要手术操作(77.4%),未采用PPD时183/200例需要手术操作(91.5%)(P<0.02)。对于经产妇,采用PPD时会阴损伤和裂伤率为11/103(10.7%),未采用PPD时为9/221(4.1%)。对于经产妇,采用PPD时共41/103例需要手术护理(39.8%),未采用PPD时,147/221例需要手术护理(66.5%)(P<0.02)。

结论

会阴阻滞麻醉更简单,所需药物更少,易于掌握,还能观察到会阴松弛,减少了会阴切开术的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f81/8976664/44c5987a3b99/OGI2022-9352540.001.jpg

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