宮睿

【摘要】 目的：探討順產(chǎn)產(chǎn)婦采用帕累托法聯(lián)合品管圈活動(dòng)，對(duì)產(chǎn)婦會(huì)陰損傷的預(yù)防和修復(fù)的臨床價(jià)值。方法：選取本院2016年4月-2017年3月入住本院的順產(chǎn)產(chǎn)婦180例作為主要觀察對(duì)象，按照隨機(jī)數(shù)字表法分為護(hù)理組（n=90）與對(duì)照組（n=90）。護(hù)理組采用帕累托法聯(lián)合品管圈活動(dòng)，對(duì)照組采用常規(guī)產(chǎn)科護(hù)理。比較兩組會(huì)陰損傷程度、會(huì)陰側(cè)切率、會(huì)陰疼痛情況及盆底功能。結(jié)果：兩組會(huì)陰裂傷程度比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;護(hù)理組側(cè)切率及會(huì)陰損傷發(fā)生率均明顯低于對(duì)照組（P<0.05）;護(hù)理組會(huì)陰疼痛程度及NRS評(píng)分均明顯低于對(duì)照組（P<0.05）;護(hù)理組產(chǎn)后3個(gè)月的盆底?、耦?lèi)及Ⅱ類(lèi)肌力均明顯高于對(duì)照組（P<0.05）。結(jié)論：順產(chǎn)產(chǎn)婦采用帕累托法聯(lián)合品管圈活動(dòng)，能夠降低產(chǎn)婦會(huì)陰側(cè)切及損傷發(fā)生率，減輕產(chǎn)婦產(chǎn)后會(huì)陰疼痛程度，且有助于產(chǎn)婦產(chǎn)后盆底肌功能恢復(fù)。

【關(guān)鍵詞】 帕累托法; 品管圈活動(dòng); 順產(chǎn); 會(huì)陰損傷

The Value of Pareto Method Combined with Quality Control Circle Activity in the Prevention and Repair of Perineal Injury in Parturients with Natural Labour/GONG Rui.//Medical Innovation of China，2019，16（22）：-109

【Abstract】 Objective：To explore the clinical value of Pareto method combined with quality control circle in the prevention and repair of perineal injury in parturient with natural labour.Method：180 cases of parturient with natural labour admitted to our hospital from April 2016 to March 2017 were selected as the main observation objects.They were divided into nursing group（n=90）and control group（n= 90）according to random number table method.The nursing group was given Pareto method combined with quality control circle activity，and the control group was given routine obstetric nursing.The degree of perineal injury，perineal resection rate，perineal pain and pelvic floor function were compared between the two groups.Result：There was no significant difference in the degree of perineal laceration between the two groups（P>0.05）.The rate of side cut and incidence of perineum injury in the nursing group were significantly lower than those in the control group（P<0.05）.The degree of perineum pain and NRS score in the nursing group were significantly lower than those in the control group （P<0.05），and the pelvic floor type Ⅰ and Ⅱ muscle strength in the nursing group were significantly higher than those in the control group（P<0.05）.Conclusion：Pareto method combined with quality control circle activity can reduce the incidence of perineal cut and injury，alleviate perineum pain and contribute to the recovery of pelvic floor muscle function.

【Key words】 Pareto method; Quality control circle activity; Natural Labour; Perineum injury

First-authors address：Jiamusi Maternal and Child Health Hospital，Jiamusi 154000，China

doi：10.3969/j.issn.1674-4985.2019.22.028

女性分娩是一個(gè)復(fù)雜的生理過(guò)程[1-2]。尤其是隨著人們的生活水平提高，胎兒的營(yíng)養(yǎng)水平改善，順產(chǎn)產(chǎn)婦的側(cè)切率也逐年上升，會(huì)陰側(cè)切雖然能夠降低會(huì)陰裂傷的發(fā)生風(fēng)險(xiǎn)，但會(huì)陰側(cè)切仍會(huì)造成產(chǎn)婦產(chǎn)后恢復(fù)時(shí)間延長(zhǎng)及盆底功能異常問(wèn)題[3-4]。帕累托法也被稱(chēng)為“二八定律”，其中涵蓋內(nèi)部控制法則，被運(yùn)用于產(chǎn)科管理尚在萌芽階段[5]。而品管圈管理已被證實(shí)，適用于產(chǎn)科護(hù)理[6-7]。但對(duì)產(chǎn)婦會(huì)陰損傷的觀察研究卻極為少見(jiàn)。因此，本研究將帕累托法和品管圈活動(dòng)相結(jié)合，并采用臨床對(duì)照研究方式明確順產(chǎn)產(chǎn)婦會(huì)陰損傷的預(yù)防及修復(fù)方面的價(jià)值，現(xiàn)報(bào)道如下。