低位产钳术临床应用及并发症的分析和评价  

Analysis and evaluation of clinical application and complications of low forceps delivery

作　　者：王国华[1] 朱虹[1] 

机构地区：[1]空军航空医学研究所附属医院妇产科,北京100089

出　　处：《哈尔滨医科大学学报》2014年第1期73-76,共4页Journal of Harbin Medical University

摘　　要：目的探讨低位产钳助产术的适应证及其对母儿的影响。方法对我院2005年1月至2012年12月住院分娩低位产钳助产产妇125例进行回顾分析。结果产钳术临床应用主要指征是胎头枕位不正(枕横或枕后位,多并发宫缩乏力)43例(34.4%);其次胎儿宫内窘迫(32例,占25.6%);继之为第二产程停滞29例(23.2%);其它的包括脐带脱垂、瘢痕子宫、巨大儿、孕妇有高血压、甲亢等内科合并症等,共21例(16.8%)。产妇并发症:主要为软产道裂伤,会阴体及阴道壁较重的裂伤6例(4.6%),无会阴Ⅲ度裂伤;宫颈裂伤8例(6.4%);产后出血6例(4.6%),仅2例和裂伤程度重、伤口出血有关,其它出血原因包括宫缩乏力在内的综合因素;尿潴留3例(2.4%)。新生儿并发症:新生儿窒息1例(0.8%);面部擦伤12例(9.6%);头皮血肿2例(1.6%);无重度新生儿窒息、新生儿死亡及严重后遗症。结论低位产钳只要选择正确适应证,严格按操作规程做,低位产钳助产术能有效尽快地缩短第二产程,紧急情况下能迅速结束分娩,解除宫内胎儿缺氧状况和减少新生儿窒息的发生率,减少母婴并发症,保证母婴安全,对降低剖宫产率有积极意义,是安全有效的阴道助产手段。Objective To investigate adaptation to low forceps delivery disease and its influ- ence on mothers and infants. Methods One hundred and twenty-five cases underwent mater- nal hospital delivery with low forceps in our hospital from January 2005 to December 2012 were retrospectively analyzed. Results The main application indications of forceps was fetal head malposition （occipitotransverse and occipitoposterior position, multiple concurrent uterine ato- ny） 43 cases （34.4%） ; secondly, fetal distress in 32 cases （25.6%） ; followed by stagnation of the second labor in 29 cases （23.2%） ; others included prolapse of umbilical cord, scar u- terus, macrosomia, pregnant women with hypertension, hyperthyroidism and other internal medical complications, a total of 21 cases （ 16. 8% ）. Maternal complications ： mainly for the soft birth canal laceration, statistical perineal and vaginal wall serious laceration in 6 cases （4.6 % ） , but no perineal laceration; 8 cases of cervical laceration （6.4%） ; 6 cases ofpostpartum hemorrhage （4. 6% ） , which resultal from comprehensive factors, mainly by weak uterine contraction, and 2 cases caused by the wound bleeding; 3 cases of urinary retention （2.4%）. Neonatal complications： 1 cases of neonatal asphyxia （0. 8% ） ; 12 cases of facial abrasions （9.6%） ; 2 cases of scalp hematoma （ 1.6% ） ; no severe neonatal asphyxia, neo- natal mortality and severe sequela. Conclusion As long as the correct choice of indications, in strict accordance with operating procedures, low forceps delivery can effectively as soon as possible to shorten the second stage of labor, emergency rapid delivery, intrauterine fetal hy- poxia condition lift and reduce the incidence of neonatal asphyxia, reduce maternal and infant complications, ensure the safety of mother and infant, and have positive significance for reduc- ing cesarean section rate, and is a safe and effective means of vaginal delivery.

关 键 词：低位产钳助产术 新生儿 阴道分娩 并发症 

分 类 号：R719.6[医药卫生—妇产科学]