剖宫产术中小产钳以枕横位助娩胎头的临床观察  

Delivering fetal head with occipitotransverse（OT） using obstetric forceps in cesarean section

作　　者：段志华 熊菊香 

机构地区：[1]湖南省南县中医院妇产科,413200

出　　处：《国际医药卫生导报》2015年第1期69-71,共3页International Medicine and Health Guidance News

摘　　要：目的探讨剖宫产术中胎头娩出困难时双叶小产钳以枕横位（OT）助娩胎头的可行性及临床价值。方法选取2007年至2013年期间我院剖宫产术中使用小双叶产钳助的116例初产妇为研究对象，其中以枕横位产钳助娩的41例，枕前位的39例，枕后位36例，记录胎头娩出时间、产钳滑脱情况及母婴损伤情况。结果在剖宫产术中产钳助娩胎头的116例中，胎头娩出时间：枕横位（OT）组（32．652．87）s，枕前位（OA）组（45．75±3．58）S，枕后位（OP）组（46．05±3．59）s；子宫切口延长：OT组1例（2．41％）、OA组1例（2．56％）、OP组1例（2．78％）；新生儿颜面损伤：OT组1例（占2．4％），OA组3例（7．7％），OP组为4例（占11．1％）；产钳滑脱率：OT组0例，OA组3例（7．69％），OP组3例（8．3％）。经统计学分析，胎头娩出时间、新生儿颜面部损伤率和产钳滑脱率有统计学意义，而产后出血、子宫切口延长率无统计学意义。结论剖宫产术中胎头娩出困难时，使用双叶小产钳以枕横位助娩胎头时胎头娩出时间短，且新生儿颜面部损伤及产钳滑脱率均较低，对产后出血以及切口撕裂伤无明显差异，值得在临床上应用推广。Objective To explore the feasibility and clinical value of delivering fetal head with occipitotransverse（OT） using obstetric forceps when having difficulty in delivering fetal head in cesarean section. Methods 116 primiparas, obstetric forceps were used in whose cesarean section, were selected from our hospital from 2007 to 2013; of which, 41 cases took occipitotransverse （OT） position, 39 occipitoanterior （OA）, and 36 occipitotransverse （OP）. The fetal head disengagement time, forceps slip, and perinatal injury were recorded. Results The mean fetal head disengagement time was （32.65 ±2.87） s in the primiparas with OT, and （45.75±3.58） s in those with OA, and （46.05±3.59） s with OE One primipara＇s incision extended in each group, respectively . One newborn （2.4%） got facial injury in OT group ,and 3 （7.69%） in OA group ,and 4 （11.1%） in OP group. The forceps slip rate was 0.0% in OT group, 7.69% （3 cases ） in OA group, and 8.3%（3 cases） in OP group. The statistical analysis showed that there were statistical differences in fetal head disengagement time, neonatal facial injury and forceps slip rate but no statistical differences in postpartum hemorrhage and uterine incision extending rate between the 3 groups. Conclusions Delivering fetal head with occipitotransverse（OT） using obstetric forceps when having difficulty in delivering fetal head in cesarean section can shorten fetal head disengagement time and lower neonatal facial injury rate and forceps slip rate, has little effect in postpartum hemorrhage and incision laceration, and is worth be clinically generalized.

关 键 词：剖宫产术 枕横位 小产钳 

分 类 号：R719.8[医药卫生—妇产科学]