头位难产中自由体位配合徒手旋转胎头矫正胎方位的研究  

Clinical Application Effect of Free Posture and Free Hand to Correct Fetal Position in Head Dystocia

作　　者：周焕娣 朱惠贻 杨林 李苗 ZHOU Huandi;ZHU Huiyi;YANG Lin;LI Miao(Department of Obstetrics and Gynecology,Dongguan Eighth People’s Hospital,Dongguan Guangdong 523000,China)

机构地区：[1]东莞市第八人民医院妇产科,广东东莞523000

出　　处：《中国卫生标准管理》2022年第11期130-132,共3页China Health Standard Management

摘　　要：目的分析头位难产中自由体位配合徒手旋转胎头矫正胎方位的临床应用及对分娩结局影响。方法回顾性选择78例2018年1月—2021年4月在东莞市第八人民医院分娩的头位难产产妇作为研究对象,根据不同的矫正方式将其分成两组,即对照组(39例)与观察组(39例)。对照组实施徒手旋转胎头矫正胎方位,观察组实施徒手旋转胎头矫正胎方位+自由体位,对比两组的胎位矫正情况、分娩结局(自然分娩、阴道助产、剖宫产)。结果观察组的第1次矫正成功率(第一产程结束前)与总成功率分别为71.79%、94.87%,对照组的第1次矫正成功率与总成功率分别为43.59%、76.92%,观察组的第1次矫正成功率与总成功率均高于对照组,差异有统计学意义(P<0.05);观察组的自然分娩率为79.49%,对照组的自然分娩率为58.97%,观察组高于对照组,差异有统计学意义(P<0.05)。结论在头位难产产妇中实施徒手旋转胎头矫正胎方位+自由体位,可以提升矫正效果,改善妊娠结局。Objective To analyze the clinical application of free position combined with free rotation of fetal head to correct fetal position in head dystocia and its influence on delivery outcome.Methods A retrospective study of 78 cases of head-position dystocia delivered in Dongguan Eighth People’s Hospital from January 2018 to April 2021 was performed.According to different correction methods,they were divided into two groups,namely the control group(39 cases)and the observation group(39 cases).The control group was treated with freehand rotation of the fetal head to correct the fetal position,and the observation group was treated with freehand rotation of the fetal head to correct the fetal position+free position.The two groups were compared for fetal position correction and delivery outcome(natural delivery,vaginal assisted delivery,cesarean section).Results The first correction success rate(before the end of the first stage of labor)and the total success rate in the observation group were 71.79%and 94.87%,respectively,and the first correction success rate and the total success rate in the control group were 43.59%and 76.92%,respectively.The first correction success rate and the total success rate in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).The natural delivery rate of the observation group was 79.49%,and that of the control group was 58.97%,which was higher in the observation group than in the control group,the difference was statistically significant(P<0.05).Conclusion In the head-position dystocia puerpera,the practice of free body position and free rotation of fetal head to correct fetal position can improve the correction effect and pregnancy outcome.

关 键 词：头位难产 自由体位 徒手旋转胎头矫正胎方位 自然分娩 阴道助产 剖宫产 矫正成功率 腹部彩超 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]