第二产程延长或停滞中应用低位产钳术与剖宫产术产妇围产期指标及新生儿预后的对比分析  

Comparative analysis of perinatal indices and neonatal outcomes of low forceps and cesarean section in prolonged or stagnant second stage of labor

作　　者：黄巧如 李子琳 周倩珺[1] 刘应锋 殷婉萍 陈静华 黄丽珊 HUANG Qiao-ru;LI Zi-lin;ZHOU Qian-jun(Department of Obstetrics and Gynecology,Dongguan Hospital,Southern Medical University(Dongguan People's Hospital),Dongguan Guangdong 523000,China)

机构地区：[1]南方医科大学附属东莞医院(东莞市人民医院)妇产科,广东东莞523000

出　　处：《临床和实验医学杂志》2022年第5期529-532,共4页Journal of Clinical and Experimental Medicine

基　　金：广东省医学科学技术研究基金项目(编号:C2019097);东莞市社会科技发展(一般)项目(编号:201950715001853)。

摘　　要：目的探究在第二产程延长或停滞时分别应用低位产钳术和剖宫产术对产妇围产期指标及新生儿预后的影响。方法回顾性选取2019年6月至2021年1月在南方医科大学附属东莞医院阴道试产且第二产程延长或停滞的120例产妇为研究对象,根据分娩方式的不同分为低位产钳术组(n=65)和剖宫产术组(n=55)。比较两组产妇围产期指标(包括第二产程时间、胎儿头部娩出时间、产时出血量、产后出血量和住院时间)及新生儿预后结局。结果低位产钳术组产妇的第二产程时间[(141.26±18.33)min vs.(152.02±19.11)min]、胎儿头部娩出时间[(6.14±0.89)min vs.(7.87±1.02)min]、产时出血量[(151.34±36.58)mL vs.(226.71±45.84)mL]、产后出血量[(177.52±41.55)mL vs.(231.35±56.80)mL]和住院时间[(3.94±0.88)d vs.(7.02±1.19)d]均明显低于对照组,差异均有统计学意义(P<0.05)。两组新生儿的出生体重[(3.82±0.69)kg vs.(3.84±0.71)kg]、1 min Apgar评分[(9.11±1.02)分vs.(9.09±0.98)分]、5 min Apgar评分[(9.45±1.36)分vs.(9.51±1.38)分]和脐带血pH值[(7.16±0.64)vs.(7.09±0.55)]比较,差异均无统计学意义(P>0.05)。低位产钳术组新生儿酸中毒、头皮血肿的发生率分别为3.08%、1.54%,明显低于剖宫产术组的14.55%、10.91%,差异均有统计学意义(P<0.05);两组新生儿窒息(1.54%vs.7.27%)、新生儿死亡(0 vs.1.82%)、皮肤损伤(1.54%vs.9.09%)的发生率比较,差异均无统计学意义(P>0.05)。结论低位产钳术助产可有效缩短分娩时间,减少产妇产时和产后出血量,降低新生儿并发症等不良预后风险,既可有效处置第二产程延长或停滞,也可降低剖宫产率。Objective To investigate the effects of low forceps and cesarean section on perinatal indexes and neonatal prognosis in prolonged or stagnant second stage of labor.Methods A total of 120 women who underwent vaginal trial labor and prolonged or stagnated second stage of labor in Dongguan Hospital,Southern Medical University(Dongguan People's Hospital)from June 2019 to January 2021 were retrospectively selected as the research objects.They were divided into low forceps group(n=65)and cesarean section group(n=55)according to different delivery methods.The perinatal indexes(including the time of the second stage of labor,the time of fetal head delivery,intrapartum blood loss,postpartum blood loss and length of hospital stay)and neonatal prognosis were compared between the two groups.Results The duration of the second stage of labor in the low forceps group and the cesarean section group[(141.26±18.33)min vs.(152.02±19.11)min],the time of fetal head delivery[(6.14±0.89)min vs.(7.87±1.02)min],the amount of intrapartum hemorrhage[(151.34±36.58)mL vs.(226.71±45.84)mL],The amount of postpartum hemorrhage[(177.52±41.55)mL vs.(231.35±56.80)mL]and the duration of hospitalization[(3.940.88)d vs.(7.02±1.19)d]were significantly different(P<0.05).There was no statistical difference in the birth weight[(3.82±0.69)kg vs.(3.84±0.71)kg],1min Apgar score[(9.11±1.02)vs.(9.09±0.98)],5 min Apgar score[(9.45±1.36)vs.(9.51±1.38)],and cord blood pH[(7.16±0.64)vs.(7.09±0.55)]between the two groups(P>0.05).The incidence rates of neonatal acidosis and scalp hematoma in the low forceps operation group were 3.08%and 1.54%,respectively,significantly lower than 14.55%and 10.91%of those in the cesarean section group(P<0.05).There was no statistical difference in the incidence of neonatal asphyxia(1.54%vs.7.27%),neonatal death(0 vs.1.82%)and skin injury(1.54%vs.9.09%)between the two groups(P>0.05).Conclusion Low forceps delivery can effectively shorten the delivery time,reduce the maternal intrapartum and postpartum hemorrhage,and

关 键 词：第二产程延长 第二产程停滞 低位产钳术 剖宫产术 新生儿预后 

分 类 号：R719.8[医药卫生—妇产科学]