Observation on the effect of midwife perineal massage care in preventing episiotomy of the perineum in primiparas
助产士会阴按摩护理在预防初产妇会阴侧切中的效果观察

摘要

目的 探讨助产士会阴按摩护理在预防初产妇会阴侧切中的应用效果。方法 选取2024年1月至2025年1月我院收治的100例初产妇，随机分为观察组50例和对照组50例。对照组采用常规产科护理，观察组在常规护理基础上增加助产士会阴按摩护理。比较两组会阴侧切率、会阴裂伤程度、产后24h会阴疼痛评分（VAS）及产后42d盆底肌力分级。结果 观察组会阴侧切率为22.0%，显著低于对照组的54.0%（P<0.05）；观察组Ⅰ度裂伤占比64.0%，高于对照组的38.0%，Ⅱ度裂伤占比14.0%，低于对照组的36.0%（P<0.05）；观察组产后24hVAS评分（2.3±0.8）分，低于对照组的（4.5±1.2）分（P<0.05）；观察组产后42d盆底肌力Ⅲ级及以上占比76.0%，高于对照组的52.0%（P<0.05）。结论 助产士会阴按摩护理可降低初产妇会阴侧切率，减轻会阴裂伤程度，缓解产后疼痛，改善盆底肌力，值得临床推广。

Abstract

Objective To explore the application effect of perineal massage nursing by midwives in preventing episiotomy in primiparas.
Methods A total of 100 primiparas admitted to our hospital from January 2024 to January 2025 were randomly divided into an observation group (50 cases) and a control group (50 cases). The control group received routine obstetric nursing care, while the observation group received perineal massage nursing by midwives in addition to the routine care. The episiotomy rate, degree of perineal laceration, perineal pain score (VAS) at 24 hours postpartum, and pelvic floor muscle strength grading at 42 days postpartum were compared between the two groups.
Results The episiotomy rate in the observation group was 22.0%, significantly lower than the 54.0% in the control group (P<0.05). The proportion of first-degree lacerations was 64.0% in the observation group, higher than the 38.0% in the control group, while the proportion of second-degree lacerations was 14.0% in the observation group, lower than the 36.0% in the control group (P<0.05). The VAS score at 24 hours postpartum was 2.3±0.8 in the observation group, lower than the 4.5±1.2 in the control group (P<0.05). The proportion of pelvic floor muscle strength grade III and above at 42 days postpartum was 76.0% in the observation group, higher than the 52.0% in the control group (P<0.05).
Conclusion   Perineal massage nursing by midwives can reduce the episiotomy rate in primiparas, alleviate the degree of perineal laceration, relieve postpartum pain, and improve pelvic floor muscle strength. It is worthy of clinical promotion.