تعیین ارتباط عوامل زایمانی و نوزادی با بهبود زخم اپی‌زیاتومی در زنان نخست زای بیمارستان امالبنین (س) شهر مشهد در سال 1392

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تربت حیدریه، تربت حیدریه، ایران.

2 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 کارشناس ارشد مامایی، بیمارستان رازی تربت حیدریه، تربت حیدریه، ایران.

چکیده

مقدمه: تأخیر ترمیم اپی‌زیاتومی منجر به نتایج بد آناتومیکی، افزایش عفونت، کاهش عملکرد جنسی، اختلال روابط عاطفی مادر و نوزاد می‌شود، ولی تحقیقات اندکی در این زمینه انجام شده است، لذا مطالعه حاضر با هدف تعیین ارتباط عوامل زایمانی و نوزادی با بهبود اپی‌زیاتومی در زنان نخست‌زا انجام شد.
روش‌کار: این مطالعه همبستگی در سال 1392 بر روی 119 مادر واجد مشخصات پژوهش مراجعه کننده به بیمارستان ام‌البنین (س) مشهد انجام شد. اطلاعات مربوط به زایمان، نوزاد و مادر با پرسشنامه‌های مربوطه جمع‌آوری و ارتباط آن‌ها با بهبود زخم اندازه‌گیری شده با فرم ریدا در روزهای اول، هفتم، دهم و چهاردهم بعد زایمان بررسی شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون‌های کولموگروف اسمیرنوف، آنالیز واریانس یک طرفه، رگرسیون، اسپیرمن و پیرسون انجام شد.میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در روز 10 و 14 بعد از زایمان طول برش پوست (037/0=p، 026/0=p)، تعداد بخیه‌های با نخ دو صفر (042/0=p، 028/0=p)، میزان فعالیت منجر به کشش و فشار در محل بخیه‌ها (037/0=p، 048/0=p) و میزان نشستن (011/0=p، 030/0=p) با ترمیم اپی‌زیاتومی همبستگی معکوس و رعایت موارد بهداشتی (048/0=p، 039/0=p) با ترمیم اپی‌زیاتومی همبستگی مستقیم داشت. درد با ترمیم اپی‌زیاتومی در روز هفتم (015/0=p) و دهم (035/0=p) همبستگی معکوسی داشت. تعداد بخیه‌های پوست (012/0=p) با ترمیم اپی‌زیاتومی در روز چهاردهم بعد زایمان همبستگی معکوسی داشت، یعنی تعداد بخیه‌های پوستی بیشتر باعث تأخیر در ترمیم زخم اپی زیاتومی شد.
نتیجه‌گیری: از میان تمامی متغیرها، برش پوستی وسیع‌تر، تعداد بیشتر بخیه‌های پوستی و بخیه‌های با نخ دو صفر، نشستن طولانی ‌مدت و ایجاد فشار و کشش در محل بخیه‌ها، درد شدیدتر اپی‌زیاتومی و عدم رعایت بهداشت باعث تأخیر ترمیم اپی‌زیاتومی می‌شوند. پیشنهاد می‌شود اهمیت این عوامل به پرسنل بهداشتی و مادران آموزش داده شود..

کلیدواژه‌ها


عنوان مقاله [English]

Relationship between delivery and neonatal factors with healing of episiotomy in primiparous women at Mashhad Omalbanin Hospital in 2013

نویسندگان [English]

  • Maryam Aradmehr 1
  • Sedigheh Azhari 2
  • Sedigheh Ahmadi 3
  • Elham Azmodeh 1
1 M.Sc. of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
2 Instructor of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 M.Sc. of Midwifery, Razi Hospital of Torbat Heydariyeh, Torbat Heydariyeh, Iran.
چکیده [English]

Introduction: Delay in episiotomy repair leads to adverse anatomic outcomes, increased infections, decreased sexual function, and impaired relationships between mother and baby, but little research has been done in this field. Therefore, this study was performed with aim to determining the relationship between delivery and neonatal factors with healing of episiotomy in primiparous women.
Methods: This correlation study was conducted on 119 eligible mothers referring to Mashhad Omolbanin Hospital in 2013. Information about delivery, neonate and mother was gathered by the questionnaires and their relationship with wound healing as measured by Reda form on 1st, 7th, 10th and 14th days after delivery was determined. Data was analyzed using SPSS software (version 16) and Kolmogorov-Smirnov, one-way ANOVA, regression, Spearman’s test, and Pearson’s correlation tests. P Results: At 10th and 14th days after delivery, inverse correlation was found between length skin incision (P=0.037, P=0.026), the number of sutures with 2/0 catgut (P=0.042, P=0.028), the activity leading to tension and pressure on the stitches (P=0.037, P=0.048), rate of sitting (P=0.011, P=0.030) with episiotomy healing; and direct correlation was found between hygiene (P=0.048, P=0.039) with episiotomy healing. Inverse correlation was found between pain and episiotomy healing at 7th (P=0.015) and 10th days (P=0.035). Also, inverse correlation was observed between the number of skin sutures (P=0.012) and episiotomy healing at 14th days after delivery; it means that more number of skin sutures leads to delay in episiotomy healing.
Conclusion: Among all variables, more extensive incision, more number of skin sutures and more sutures with 2/0 catgut, long sitting, tension and pressure on the stitches, severe episiotomy pain and lack of hygiene lead to delay in healing of episiotomy. Therefore, it is recommended to train health care providers and mothers about these factors.

کلیدواژه‌ها [English]

  • Episiotomy
  • Perineum
  • Wound healing
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