胎儿脐带绕颈临产产妇体位的护理研究  

Nursing Research of Fetal Umbilical Cord around Neck Posture of Parturient

作　　者：周桂梅[1] 梁卡加 钟思敏[1] 王小言[1] 

机构地区：[1]湛江市妇幼保健院,广东湛江524038

出　　处：《中国初级卫生保健》2015年第5期121-122,共2页Chinese Primary Health Care

摘　　要：目的探讨脐带绕颈临产孕妇体位的护理效果。方法将2009年1月—2011年10月在我院B超提示脐带绕颈,将第一、二产程持续胎心监护出现变异减速的足月临产孕妇400例随机分为观察组和对照组,每组各200例。观察组孕妇在左侧卧位胎心监护变异减速未见改善的情况下,指导其采取右侧卧位、坐位或半坐卧位,观察胎心改善情况,随时调整孕妇体位,达到最佳的胎心分娩过程。对照组孕妇常规以左侧卧位或仰卧位进行胎心监护,由产妇自行调节体位,以自觉舒适为宜。观察两组产妇胎心变异减速情况、监护曲线图、分娩方式和结局。结果两组孕妇胎心监护轻度异常图形的差异无统计学意义(P>0.05);而中、重度变异减速(VD)观察组比对照组分别少1.5倍和7倍,胎儿宫内窘迫、新生儿窒息率明显减少,剖宫产率也减少1倍多,两组比较差异均有统计学意义(P<0.05)。结论左侧卧位胎心监护仍有变异减速的脐带绕颈临产孕妇,经改变体位后,脐带绕颈所造成的压迫解除,胎心监护曲线恢复正常,胎儿宫内窘迫、新生儿窒息率减少,因此,分娩过程中出现胎心基线变异减速时,体位指导是首选的护理干预措施。OBJECTIVE To explore the nursing of umbilical cord around neck parturient position effect. METHODS From January to 2011 to October 2009 suggest that umbilical cord around the neck in our hospital B ultrasound, in the first stage of labor, continu- ous fetal heart monitoring appears variable deceleration full-term parturient in 400 eases, were randomly divided into observation group and control group with 200 cases in each group. The observation group： the left lateral deeubitus position monitoring of fetal heart rate variability reduction was not improved, guide mothers take the right lateral decubitus position, sitting or semi reclining po- sition, observation of the fetal heart to improve the situation, adjust the position of parturient fetal heart at any time, achieve the best delivery process. Control group： routine with a left lateral decubitus or supine of fetal heart monitoring, self adjustment by ma- ternal posture consciously comfortable; observation group two variable decelerations, monitoring curves, mode of delivery and out- come. RESULTS There was no significant difference between the two groups, the fetal heart rate monitoring mild abnormal graph- ics（P〉0.05）; and in severe variable deeeleration（VD） observation group than in the control group were 1.5 and 7 times, fetal dis- tress, neonatal asphyxia rate is obviously reduced, the rate of cesarean section was also reduced more than doubled, group two comparison of the difference was significant（P〈0.05）. CONCLUSION The left decubitus fetal heart monitoring were still variable de- celeration of umbilical cord around neck parturient, by a change of position, umbilical cord around the neck caused by relieving compression, fetal heart rate curve returned to normal, fetal distress, neonatal asphyxia rate reduce, therefore, during delivery de- celeration baseline fetal heart variability, postural guidance was the nursing intervention of choice.

关 键 词：胎心监护 变异减速 脐带绕颈 体位 护理 

分 类 号：R47[医药卫生—护理学]