徒手复位旋转胎头降低头位难产的临床应用研究  

Study on clinical application of manual reduction and rotation of fetal head in reducing head dystocia

作　　者：江钧 

机构地区：[1]四川省绵阳市科学城医院,621000

出　　处：《中国实用医药》2017年第35期9-11,共3页China Practical Medicine

摘　　要：目的分析徒手复位旋转胎头降低头位难产的临床应用效果。方法 64例头位难产的产妇,随机分为研究组和比较组,每组32例。比较组采用常规产程自然旋转分娩法,研究组则采用徒手复位旋转胎头法纠正头位难产,比较两组产妇最终分娩方式、产程时间、产后出血量及新生儿并发症的发生情况。结果研究组产妇阴道助产5例,占比15.6%,自然分娩23例,占比71.9%,剖宫产4例,占比12.5%;比较组产妇阴道助产6例,占比18.8%,自然分娩8例,占比25.0%,剖宫产18例,占比56.3%;研究组剖宫产率低于比较组,自然分娩率高于比较组,差异有统计学意义(P<0.05)。研究组产程时间为(10.4±2.3)h,产后出血量为(201.15±34.20)ml,比较组产程时间为(16.1±3.5)h,产后出血量为(278.31±26.30)ml;研究组产妇产程时间及产后出血量均显著优于比较组,差异有统计学意义(P<0.05)。研究组并发症发生率为9.4%,比较组并发症发生率为31.3%;研究组新生儿并发症发生率显著低于比较组,差异有统计学意义(P<0.05)。结论在头位难产产妇分娩时,采用徒手复位旋转胎头能够有效纠正胎头,促进产妇自然分娩,缩短产程,并降低产后出血量及新生儿并发症的发生率,值得临床推广应用。Objective To analyze the clinical application effect of manual reduction and rotation of fetal head in reducing head dystocia. Methods A total of 64 head dystocia puerpera were randomly divided into research group and control group, with 32 cases in each group. The control group received natural rotation delivery method in routine labor, and the research group received manual reduction and rotation of fetal head. Comparison were made on final mode of delivery, labor duration, postpartum hemorrhage, and neonatal complications between two groups. Results The research group had 5 vaginal midwifery cases, accounting for 15.6%, 23 natural delivery cases, accounting for 71.9%, 4 cesarean section cases, accounting for 12.5%. The control group had 6 vaginal midwifery cases, accounting for 18.8%, 8 natural delivery cases, accounting for 25.0%, 18 cesarean section cases, accounting for 56.3%. The research group had lower cesarean section rate than control group, higher natural delivery rate than the control group. Their difference was statistically significant（P〈0.05）. The research group had duration of labor as（10.4±2.3） h, postpartum hemorrhage volume as（201.15±34.20） ml, which were（16.1±3.5） h and（278.31±26.30） ml in the control group. The research group had obviously better duration of labor and postpartum hemorrhage volume than the control group, and their difference was statistically significant（P〈0.05）. The research group had incidence of complications as 9.4%, which was 31.3% in the control group. The research group had obviously lower incidence of complications than the control group, and the difference was statistically significant（P〈0.05）. Conclusion For head dystocia delivery, manual reduction and rotation of fetal head can effectively correct the fetal head, promote natural delivery, shorten the production process, and reduce the amount of postpartum hemorrhage and incidence of neonatal complications. It is worthy of clinical promotion and application.

关 键 词：徒手复位 旋转胎头 头位难产 临床应用 

分 类 号：R714.4[医药卫生—妇产科学]