侧卧位的角度与纠正枕后位的关系探讨  

The relationship between the angle of lateral recumbent position and correcting occipitoposterior position

作　　者：陈东东[1] 陈佳权[1] 韩文[1] 

机构地区：[1]牡丹江医学院附属二院妇产科,黑龙江牡丹江157010

出　　处：《中国妇幼保健》2011年第14期2197-2198,共2页Maternal and Child Health Care of China

摘　　要：目的:探讨孕妇侧卧位的角度与纠正枕后位的关系。方法:选择2004年1月～2010年1月于牡丹江医学院附属二院妇产科分娩经彩超及产科检查确诊为枕后位、无明显产道异常或头盆不称、年龄20～32岁的初产妇200例,随机平均分为观察组和对照组。两组宫缩时均取跪位,宫缩间歇时,观察组同侧俯卧位(同侧俯卧>90°);对照组对侧俯卧位(对侧俯卧>90°且向对侧旋转后儿头枕部超过12:00)。结果:观察组90%转为枕前位经阴道分娩,10%剖宫产;对照组78%转为枕前位经阴道分娩,20%剖宫产。结论:侧卧位的角度与纠正枕后位的成功率关系密切。纠正枕后位时可采取跪位(180°)、同侧俯卧位(>90°)、同侧卧位(90°)、及对侧俯卧位(对侧俯卧>90°且儿头枕部超过12:00);若对侧俯卧<90°或对侧俯卧>90°但儿头枕部不超过12:00,胎儿将继续向枕后位旋转;若对侧俯卧胎儿枕部位于12:00,胎位不变。Objective：To explore the relationship between the angle of lateral recumbent position and correcting occipitoposterior position.Methods：200 primiparae who delivered and had occipitoposterior position,no obvious abnormal vaginal or cephalopelvic disproportion from January 2004 to January 2010 in our hospital were selected and divided into observation group and control group.During uterine contraction,the patients of two groups took kneeling position.During the free time of uterine contraction,the patients of observation group took homolateral prone position,and the patients of control group took contralateral prone position.Results：In observation group,90% patients were changed into occipitoanteror position and were vaginal delivery,10% patients were cesarean section.In control group,78% patients were changed into occipitoanteror position and were vaginal delivery,20% patients were cesarean section.Conclusion：The angle of lateral recumbent position is closely related with the success rate of correcting occipitoposterior position.In order to correct occipitoposterior position,squatting position（180°）,homolateral prone position（90°）,homolateral lying position（90°） and contralateral prone position should be used.

关 键 词：侧卧位 枕后位 成功率 

分 类 号：R714.44[医药卫生—妇产科学]