第二产程不同体位娩出胎儿的临床应用效果  

Clinical application effects of delivery fetus in different postures during second stage of labor

作　　者：夏华安[1] 江紫妍[1] 胡静[1] 罗太珍[1] 黄美凌[1] XIA Hua - an ;JIANG Zi - yan;HU Jing;LUO Tai -zhen;HUANG Mei - ling(Delivery Room, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510150, P. R. China)

机构地区：[1]广州医科大学附属第三医院产房,广东广州510150

出　　处：《中国计划生育和妇产科》2019年第1期41-44,52,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：2015年广东省医学科学技术研究基金项目(项目编号:A 2015174);广州医科大学附属第三医院青年基金(项目编号:2015Y13)

摘　　要：目的探讨第二产程中不同体位娩出胎儿在临床中的应用效果。方法选择广州医科大学附属第三医院2015年11月至2016年10月待产的200例足月产妇,全产程实施自由体位分娩,根据第二产程胎头拨露或着冠时产妇选择的分娩体位分为6组,即坐位、站位、跪趴位、蹲位、侧卧位和截石位,比较分析各组分娩结局。结果不同体位娩出胎儿对第二产程时间、产时出血和产后2 h出血量的影响比较,差异有统计学意义(χ~2=24. 063、18. 569、12. 700,P <0. 05),对会阴裂伤程度影响比较,差异无统计学意义(χ~2=11. 037,P>0. 05)。结论在不同分娩体位中,站位、跪趴位、蹲位分娩的第二产程时间较短,虽然直立体位,如站位、坐位、蹲位产时出血和产后2 h出血量稍多,但未达到产后出血的诊断标准。Objective To explored the clinical application effect of delivering in different positions during second stage of labor.Methods Selected 200 full-term maternity women from November 2015 to October 2016 in the Third Affiliated Hospital of Guangzhou Medical University to perform free posture delivery,according to the chosen posture in second stage of labor,when the fetal head was exposed or crowned,divided them into 6 groups: sitting,standing,kneeling,squatting,lateral position and lithotomy position. Compared pregnancy outcomens of the 6 groups. Results There were significant differences in duration of second stage of labor,intrapartum hemorrhage and 2 hours after delivery hemorrhage among different delivery position groups( χ^2= 24. 063、18. 569、12. 700,P < 0. 05),but no statistically significant difference in the degree of perineal laceration( χ^2= 11. 037,P > 0. 05). Conclusion Among these different delivery groups,the duration of second stage of labor was shorter in standing,kneeing and squatting groups.The intrapartum hemorrhage and 2 hours after delivery was greater in upright position group,such as in standing,sitting and squatting groups,but the blood loss in each group did not meet the criteria of postpartum hemorrhage.

关 键 词：自由体位 分娩 不同体位分娩 应用效果 

分 类 号：R719.3[医药卫生—妇产科学]