基于RCT对比Friedman与新产程对阴道试产成功率及母婴结局影响的临床研究  

Clininal Study Based on RCT Comparing Friedman and New Labor Process on Success Rate of Vaginal Trial Delivery and Mother-Infant Outcomes

作　　者：李丽霞[1] 韩文莹 李明巧 朱晓明[2] LI Lixia;HAN Wenying;LI Mingqiao;ZHU Xiaoming(The First Department of Obstetrics,the Second People's Hospital of Hengshui,Hengshui Hebei 053000,China)

机构地区：[1]衡水市第二人民医院产一科,河北衡水053000 [2]解放军总医院海南医院妇产科

出　　处：《华南国防医学杂志》2021年第11期792-795,共4页Military Medical Journal of South China

基　　金：国家自然科学基金面上项目(81471474);河北省衡水市科技计划项目(2018014020Z)。

摘　　要：目的基于随机对照试验(randomized controlled trials,RCT)对比Friedman与新产程的不同并发症与新生儿不良结局发生率的多因素分析。方法采用随机对照研究方法选取2018-09/2020-04月于作者医院产科阴道试产的260例产妇为研究对象,其中130例产妇实施新产程标准为观察组,另外130例产妇实施Friedman产程标准处理为对照组。观察比较两组产妇的阴道试产成功率、产妇并发症发生情况及新生儿结局。结果观察组阴道试产成功率明显高于对照组,差异有统计学意义[80.0%(104/130)vs.66.2%(86/130),P<0.05]。观察组的产后出血发生率明显高于对照组,差异有统计学意义[12.3%(16/130)vs.3.1%(4/130),P<0.05]。观察组胎儿宫内窘迫、新生儿窒息、新生儿黄疸、新生儿肺炎的发生率与对照组比较,差异均无统计学意义(P>0.05)。结论实施新产程标准,提高了阴道试产成功率,降低了剖宫产率,且不会增加新生儿不良结局发生的风险。产后宫缩乏力与产后出血的发生应引起重视,早发现早干预是预防产妇不良结局的有效途径。Objective To multifactorial analyze basing on randomized controlled trials(RCT)comparing Friedman and different complications of the new labor process and the incidence of adverse neonatal outcomes.Methods A total of 260 cases of parturients in author′s hospital from September 2018 to April 2020 were selected as the research objects.Among them,130 cases of parturients were treated with the new labor process standard,which were selected as the observation group,and the other 130 cases were treated with the Friedman labor process standard,which were regarded as the control group.The success rate of vaginal trial delivery,parturient complications and neonatal outcomes were observed and compared between the two groups.Results The success rate of vaginal trial delivery in the observation group was significantly higher than that of the control group[80.0%(104/130)vs.66.2%(86/130),P<0.05].The incidence of postpartum hemorrhage was significantly higher than that of the control group,the difference was statistically significant[12.3%(16/130)vs.3.1%(4/130),P<0.05].There was no significant difference in the incidence of fetal distress,neonatal asphyxia,neonatal jaundice and neonatal pneumonia between the observation group and the control group(P>0.05).Conclusion According to the new labor process standard,it can improve the success rate of vaginal trial delivery,reduce the cesarean section rate,and will not increase the risk of neonatal adverse outcomes.But the occurrence of postpartum uterine inertia and postpartum hemorrhage should be paid attention to.Early detection and intervention are an effective way to prevent maternal adverse outcomes.

关 键 词：新产程 阴道试产 母婴预后 不良结局 

分 类 号：R714[医药卫生—妇产科学]