孕晚期会阴按摩对初产妇会阴损伤的影响

Impact of Perineal Massage on Perineal Injury in Primiparous Women in Late Pregnancy

摘要: 目的：探讨孕晚期会阴按摩对初产妇会阴损伤的影响。方法：选择2025年1月至8月于深圳市福田区妇幼保健院定期产检并分娩的260例孕妇为研究对象，所有孕妇均为初产妇，采取随机抽样法进行分组，对照组130例孕妇采取常规干预，研究组130例孕妇在常规干预的基础上加用会阴按摩。比较分析两组孕妇的会阴损伤、会阴裂伤程度与会阴按摩次数的相关性、产程时间、会阴水肿及产时出血量的情况。结果：在会阴完整性的发生率上，研究组高于对照组，但会阴侧切率低于对照组，两组差异具有统计学意义(P < 0.05)；会阴裂伤程度与会阴按摩次数呈显著弱的负相关关系(r_s = −0.296, P = 0.001)；相较于对照组，研究组第二产程时间较短、会阴水肿发生率较低，两组差异具有统计学意义(P < 0.05)；但两组孕妇第一产程、第三产程、总产程及产时出血量无明显差异(P > 0.05)。结论：综上所述，孕晚期对初产妇实施会阴按摩可提高会阴完整性，降低会阴侧切发生风险，并且会阴裂伤程度随着会阴按摩次数的增加而下降；同时会阴按摩可促进第二产程进展，减少会阴水肿的发生，临床上值得推广应用。

Abstract: Objective: To explore the impact of perineal massage on perineal injury in primiparous women in late pregnancy. Methods: A total of 260 pregnant women who underwent regular prenatal checkups and delivered at Shenzhen Futian District Maternal and Child Health Hospital from January to August 2025 were selected as research subjects. All participants were primiparous women, and the groups were randomly assigned through sampling. The control group of 130 pregnant women received routine interventions, while the study group received routine interventions and perineal massage. We compared and analyzed the perineal injury, correlation between degree of perineal laceration and times of perineal massage, stage of labor, perineal edema and blood loss during delivery in two groups of pregnant women. Results: The study group showed a higher incidence of perineal integrity than the control group, but a lower rate of episiotomy, with statistically significant differences between the two groups (P < 0.05). There was a significantly weak negative correlation between the severity of perineal laceration and times of perineal massage (r_s = −0.296, P = 0.001). Compared with the control group, the second stage of labor in the study group was shorter and the incidence of perineal edema was lower, which was statistically significant (P < 0.05). However, there was no significant difference in the first stage, third stage, total stage and blood loss during delivery between the two groups of pregnant women (P > 0.05). Conclusions: In summary, perineal massage for primiparous women in late pregnancy can enhance perineal integrity, reduce the risk of episiotomy, and decrease the degree of perineal laceration with increased massage frequency. Additionally, it accelerates the second stage and reduces perineal edema, making it clinically valuable for clinical application.