产程中改变体位法矫正枕后位效果浅析  

The Effect Analysis of the Change of Mother's Body Position on Fetus Occipitoposterior Position Correction during the Course of the Child's Birth

作　　者：周芹[1] 黄雨[2] 

机构地区：[1]广东药学院第二附属医院妇产科 [2]广东药学院第二附属医院大内科,广东广州510300

出　　处：《辽宁医学院学报》2016年第4期26-29,共4页Journal of Liaoning Medical University (LNMU) Bimonthly

摘　　要：目的 对产程中指导产妇行与胎背同侧的侧俯卧位以矫正枕后位效果观察。方法 选择第一产程进入活跃期后取诊断为枕后位而无明显头盆不称的产妇120例,随机分为研究组和对照组,每组60例,指导研究组产妇与胎背同侧的侧俯卧位纠正胎位;对照组产妇常规护理,观察两组产妇分娩方法、产程进展及胎儿、新生儿情况。结果 研究组胎头转正率为91.79%（55/60）,对照组胎头转正率为56.7%（34/60）,组间差异有统计学意义（χ^2=19.181,P=0.000）。研究组阴道分娩率为91.7%（55/60）,显著高于对照组的55.0%（33/60）。研究组剖宫产率为8.3%（5/60）,显著低于对照组的45.0%（27/60）,差异均有统计学意义（χ2=20.625,P=0.000）。研究组第一产程、第二产程的潜伏期、活跃期时间均明显低于对照组的,差异具有统计学意义（P〈0.05）;研究组胎先露速度明高于对照组的,差异具有统计学意义（t=2.513,P=0.014）。研究组胎儿宫内窘迫发生率为3.3%,明显低于对照组的16.6%,差异具有统计学意义（χ^2=5.926,P=0.015）;研究组阿氏评分4-7分发生率为3.3%,明显低于对照组的15.0%,差异具有统计学意义（χ^2=4.904,P=0.027）。研究组产妇产后出血量（165.05±70.97）m L明显少于对照组产妇产后出血量（220.00±124.89）m L（t=2.963,P=0.004）。结论 在产程中指导产妇采取与胎背同侧的侧俯卧位对纠正枕后位是有效的,可降低手术产率,提高产科的分娩质量,且方法简单,易于在临床推广使用。Objective To observe the effects of mother＇s lateral prostrate position, homolateral with the fetal back, on correcting the oecipitoposterior position of the fetus during the course of the child＇s birth. Methods 120 cases, diagnosed with fetal occipitopos- terior position without obvious cephalopelvic disproportion in the active phase of the first stage, were selected and randomly divided into two groups, with 60 cases in the research group and 60 cases in the control group. The puerperae in the research group were instructed to take the lateral prostrate position, homolateral with the fetal back, to correct the position of fetus; whereas the puerperae in the control group were treated with routine nursing. The methods of delivery, the progress of child＇s birth and the conditions of the fetuses and newborns were observed. Results The correction rate of fetal head position was 91.79% （55/60） in the research group and that was 56. 7% （34/60） in the control group. The differences between the two groups had statistical significance with χ^2= 19. 181 and P = 0. 000. The rate of vaginal delivery in the research group was 91.7% （55/60）, which was significantly higher than that in the con- trol group, 55.0% （33/60）. Moreover, the rate of uterine incision delivery in the research group was 8. 3% （5/60）, which was significantly lower than that in the control group, 45.0% （27/60）. There were statistically significant differences between two groups （ χ^2 = 20. 625, P = 0. 000）. Besides, the incubation periods and active phases in the first and second stages of the research group were significantly shorter than that of the control group. The differences were statistically significant （ P〈0. 05 ）. The fetal presentation speed of the research group was much higher than that of the control group with the differences being statistically significant （t = 2. 513, P = 0. 014） . The incidence of fetal intrauterine distress of the research group was 3.3% , which was significantly lower tha

关 键 词：枕后位 侧俯卧位 分娩 

分 类 号：R714.15[医药卫生—妇产科学]