个性化体位指导在耻骨联合过长产妇分娩中的应用  

Application of personalized position guidance during parturition of pregnant women with pubic union overlength

作　　者：赵芳菲[1] 王玉芳[1] 赵力艳[2] 孙玉荣[1] 刘淑艳[1] 陈燕[1] 

机构地区：[1]河北联合大学附属医院产科,唐山063000 [2]河北省遵化市人民医院产科,064200

出　　处：《中华灾害救援医学》2015年第6期332-335,共4页Chinese Journal of Disaster Medicine

基　　金：唐山市科技计划项目(13130205a)

摘　　要：目的比较前倾站位和夸张截石位在耻骨联合过长产妇分娩中的应用效果。方法将骨盆外测量正常,耻骨联合过长的产妇90例,在第二产程根据产妇意愿分为观察组(n=44)和对照组(n=46)。观察组采用前倾站位,直至胎头着冠再上产床分娩;对照组采用夸张截石位,观察并记录各产程时间、中转剖宫产率、两组疼痛情况、新生儿窒息发生率和产后出血发生率。结果观察组第二产程时间为(40.5±18.4)min,显著短于对照组的(95.3±22.9)min(F=7.820,P=0.009);观察组总产程时间为(636.1±86.5)min,较对照组的(720.2±107.3)min明显更短,差异有统计学意义(F=4.572,P=0.043);观察组中转剖宫产率为2.3%(1/44),显著低于对照组的17.4%(8/46)(P=0.0304);观察组第二产程疼痛程度比对照组明显减轻(Zc=-2.871,P=0.004);观察组新生儿窒息发生例数明显少于对照组,差异有统计学意义(Zc=-2.160,P=0.031);观察组产后出血大于500 ml的人数少于对照组(Zc=-2.160,P=0.031)。结论在骨盆外测量正常,耻骨联合过长产妇的分娩过程中,采取前倾站位,能够缩短产程,减轻疼痛,降低剖宫产率,减少产后出血,促进自然分娩。Objective To compare the effect of forward position and exaggerated lithotomy position during parturition of preg- nant women with pubic union overlength. Methods 90 cases of pregnant women with pubic union overlength hut normal pelvis outer measurement, were divided into observation group （ n = 44 ） and control group （ n = 46） in the second stage of labor according to their willingness. Forward position was applied in observation group until crowning of head then delivered on obstetric table, and exaggerated lithotomy position was applied in control group. Time of each labor stage, rate of transiting cesarean, degree of pain, incidence of neo- natal asphyxia and the incidence of postpartum hemorrhage were observed and recorded. Results The time of second stage of labor in observation group was （40.5 ± 18.4） rain, which was significantly shorter than those in control group （95.3± 22.9） min （F = 7. 820, P = 0. 009）. The total labor time in observation group was （636.1±g6.5 ） rain, which was much shorter than those in control group （ 720.2 ± 107.3 ） rain, the difference was statistically significant （ F = 4. 572, P = 0. 043 ） ; The rate of transiting cesarean in observation group was 2.3 % （1/44） , which was significantly shorter than control group 17.4 % （ 8/46 ） （ P = 0. 030d ） ; Degree of pain in observation group was significantly less than control group （Zc = -2. g71, P = 0. 004） ; Incidence of neonatal asphyxia in ob- servation group was less than control group, the difference was statistically significant （Zc = -2. 160, P = 0. 031 ） ; Incidence of post- partum hemorrhage more than 500 ml was significantly less than control group （ Zc = - 2.160, P = 0. 031 ）. Conclusions During par- turition, for pregnant women with pubic union overlength but normal pelvis outer measurement, forward position can shorten labor process, reduce degree of pain, lower the rate of cesarean as well as reduce postpartum hemorrhage, and promote natural delivery.

关 键 词：前倾站位 耻骨联合过长 第二产程 分娩 

分 类 号：R714[医药卫生—妇产科学]