半卧位屈大腿抱膝法的分娩体位对母婴影响的研究  

Study on Impacts of Childbirth Position of Semireclining Thigh-bending and Knee-embracing on the Mother and Infant

作　　者：黄海燕[1] 郑红雨[2] 

机构地区：[1]广西壮族自治区人民医院产科,南宁530021 [2]广西壮族自治区人民医院超声科,南宁530021

出　　处：《医学综述》2014年第13期2443-2444,共2页Medical Recapitulate

基　　金：广西卫生厅课题(桂卫Z2012290)

摘　　要：目的探讨第二产程采用半卧位屈大腿抱膝法的分娩体位对母婴的影响。方法将广西壮族自治区人民医院产科于2012年3月至6月收治的拟采用阴道分娩的足月妊娠单胎头位初产妇180例根据分娩日期的单双日分为半卧抱膝位组(90例)和仰卧屈膝位组(90例)。半卧抱膝位组采用半卧位屈大腿抱膝法分娩体位;仰卧屈膝位组采用仰卧屈膝位分娩体位。观察并比较两组产妇第二产程时间、分娩方式、肩难产、会阴伤口的愈合情况、阴道分娩产妇产后6个月盆底功能及新生儿窒息率的差异。结果半卧抱膝位组产妇第二产程[(41.6±5.2)min]显著短于仰卧屈膝位组[(63.6±4.8)min](t=13.180,P<0.05),其肩难产发生率显著低于仰卧屈膝位组(χ2=6.776,P<0.05),两组产妇分娩方式、阴伤口愈合情况以及新生儿窒息情况比较差异具有统计学意义(P<0.05),半卧抱膝位组产妇子宫脱垂和阴道壁膨出情况显著好于仰卧屈膝位组(χ2=4.470,P=0.034),盆底肌综合收缩力显著优于仰卧屈膝位组(Z=-3.959,P<0.05)。结论半卧位屈大腿抱膝法的分娩体位缩短了第二产程,增加了产妇分娩时的舒适感,降低了母婴并发症的发生率,值得临床推广应用。Objective To investigate the impact of childbirth position of semireclining thigh-bending and knee-embracing on mothers and infants during the second stage of labor. Methods One hundred and eighty full-term singleton pregnancy primiparae in head delivery vaginally ,who were admitted to the Obstetrical Department of Guangxi Zhuang Autonomous Region People＇s Hospitalfrom March to June 2012 were randomly divided into semi-recumbent position group （90 primiparae ） and supine position group （90 primiparae ）. Childbirth position of semireclining thigh-bending and knee-embracing was used in semi-recumbent position group, while traditional childbirth position was used in supine position group. Differences of duration of the second stage of labor,delivery mode, incidence of shoulder dystocia, perineal wound healing, 6 months postpartum pelvic floor function of primipara who delivered vaginally, as well as the rate of neonatal asphyxia were observed. Results The duration of second stage labor of the semi-recumbent position group[ （41.6 ±5.2） min] was significantly lower than that of the supine position group[ （63.6 ±4.8 ） mini （ t = 13. 180 ,P 〈 0.05 ）. The occurrence of shoulder dystocia of the semi-recumbent position group was significantly lower than the supine position group （χ^2 =6. 776 ,P 〈0.05 ）. The differences of mode of delivery,healing of perineal wound and occurrence of neonatal asphyxia rate between the two groups were statistically signifieant（ P 〈 0.05 ）. The uterine prolapse and neonatal asphyxia situation of semi-recumbent position group were significantly better than the supine position group（ χ^2 =4. 470,P =0.034）. The pelvic floor muscle eontraetion of the semi-recumbent position group was obviously superior than that of the supine position group（Z = -3. 959,P 〈0.05）. Conclusion Semireclining thigh-bending and knee-embracing delivery position can shorten the second stage of labor, inerease comfort during labor and reduce the incidence of maternal and ne

关 键 词：第二产程 半卧位屈大腿抱膝法 盆底功能 

分 类 号：R714.4[医药卫生—妇产科学]