帕累托法联合品管圈活动在顺产产妇会阴损伤预防与修复价值

宫睿

【摘要】 目的：探讨顺产产妇采用帕累托法联合品管圈活动，对产妇会阴损伤的预防和修复的临床价值。方法：选取本院2016年4月-2017年3月入住本院的顺产产妇180例作为主要观察对象，按照随机数字表法分为护理组（n=90）与对照组（n=90）。护理组采用帕累托法联合品管圈活动，对照组采用常规产科护理。比较两组会阴损伤程度、会阴侧切率、会阴疼痛情况及盆底功能。结果：两组会阴裂伤程度比较，差异无统计学意义（P>0.05）;护理组侧切率及会阴损伤发生率均明显低于对照组（P<0.05）;护理组会阴疼痛程度及NRS评分均明显低于对照组（P<0.05）;护理组产后3个月的盆底肌Ⅰ类及Ⅱ类肌力均明显高于对照组（P<0.05）。结论：顺产产妇采用帕累托法联合品管圈活动，能够降低产妇会阴侧切及损伤发生率，减轻产妇产后会阴疼痛程度，且有助于产妇产后盆底肌功能恢复。

【关键词】 帕累托法; 品管圈活动; 顺产; 会阴损伤

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

女性分娩是一個复杂的生理过程[1-2]。尤其是随着人们的生活水平提高，胎儿的营养水平改善，顺产产妇的侧切率也逐年上升，会阴侧切虽然能够降低会阴裂伤的发生风险，但会阴侧切仍会造成产妇产后恢复时间延长及盆底功能异常问题[3-4]。帕累托法也被称为“二八定律”，其中涵盖内部控制法则，被运用于产科管理尚在萌芽阶段[5]。而品管圈管理已被证实，适用于产科护理[6-7]。但对产妇会阴损伤的观察研究却极为少见。因此，本研究将帕累托法和品管圈活动相结合，并采用临床对照研究方式明确顺产产妇会阴损伤的预防及修复方面的价值，现报道如下。