第二产程胎心监护异常图形对新生儿预后的影响  

The effect of abnormal cardiotocography during the second stage of labor on neonatal prognosis

作　　者：任长慧[1] 许圣菊[1] 亓效香[1] 

机构地区：[1]泰山医学院附属医院产科,山东泰安271000

出　　处：《泰山医学院学报》2008年第7期530-532,共3页Journal of Taishan Medical College

摘　　要：目的将第二产程胎心监护异常图形分为良好图形和不良图形,探讨其对产程处理的指导意义。方法2007年1-2008年1月1000例胎心监护图形（CTG）中的512例（51.2%）为异常图形,将512例异常图形分为良好图形315例（对照组）,不良图形197例（观察组）,对比两组图形对新生儿预后的影响。结果观察组脐带绕颈（18.7%）明显高于对照组（5.2%）,P〈0.05;阴道助产（11.2%）、剖宫产率（26.1%）明显高于对照组（3.2%、6.5%）,P〈0.05、P〈0.01;Ⅱ°-Ⅲ°羊水粪染（13.4%）高于对照组（1.9%）,P〈0.05;第二产程时限（35±21）min明显短于对照组（60±30）min,P〈0.01;新生儿窒息两组差异无显著性（4.5%、2.6%）,P〉0.05。观察组异常图形为持续性心动过缓,频发VD及LD、PD,甚至出现基线变异减弱或消失;对照组为一过性心动过速,偶发ED、VD或LD、PD,无基线变异减弱或消失。结论良好图形为一过性偶发的异常图形,不良图形为持续性、频发的异常图形;对良好图形密切观察,防止过早干预,对不良图形应积极处理,防止造成不良后果。Objective： To investigate the relationship between the good cardiotocography （CTG） and the poor CTG divided by abnormal CTG during the second stage of labor and neonatal prognosis. Methods： The abnormal CTG of 512 uniparas with single vertex in the second stage of labor in the good CTG （315 cases in the control group） and the poor CTG （197 cases in the study group） were analyzed retrospectively. Results： Umbilical cord around neck （18.7%）, the incidence of cesarean section （26.1%）, Ⅱ° - Ⅲ° moor meconium- stained amniotic fluid （13.4%） in the study group were higher respectively than those in the control group （5.2%, 6.5 %, 1.9% ; P 〈 0.05, P 〈 0.01, P 〈 0.05 ）, and time of the second stage of labor[ （35 ± 21 ） min ] in the study group was shorter than that in the control group [ （60 ± 30） min ] （P 〈0.01 ）, but rate of neonatal asphyxia was not statistically significant （P 〉 0.05 ）. Abnormal CTG were observed with continuous bradycardia, frequently mild and severe variable deceleration （VD） and late deceleration （LD） and prolonged deceleration（PD） and diminished baseline variability （DBV） in the study group, with occasionally bradycardia and early deceleration （ED） or VD and LD or PD and noDBV in the control group. Conclusion： The good CTG is occasionally abnormal CTG and the poor CTG is frequently abnormal CTG. It is unnecessary to intervene immediately in the good CTG and necessary to actively intervene in the poor CTG.

关 键 词：第二产程 胎心监护 异常图形 新生儿预后 

分 类 号：R473.71[医药卫生—护理学]