徒手旋转胎头术治疗枕横位和枕后位难产的价值分析  

Analysis of the value of freehand rotation of the fetal head in the treatment of dystocia in occipital transverse position and occipital posterior position

作　　者：金艳 JIN Yan(Liaoning Provincial Maternal and Child Health Hospital and Liaoning Provincial Women and Children's Hospital,Shenyang 110005,China)

机构地区：[1]辽宁省妇幼保健院暨辽宁省妇女儿童医院,110005

出　　处：《中国实用医药》2023年第8期44-46,共3页China Practical Medicine

摘　　要：目的分析徒手旋转胎头术治疗枕横位和枕后位难产的临床价值。方法64例枕横位和枕后位难产产妇为研究对象,采用随机抽签法分为实验组和对照组,各32例。对照组采用常规分娩方式,实验组采用徒手旋转胎头术进行治疗。比较两组产妇的自然分娩、产后感染发生情况,产程时长,新生儿情况及新生儿产伤情况。结果实验组自然分娩29例,产后感染3例;对照组自然分娩22例,产后感染11例。实验组自然分娩率、产后感染发生率均显著优于对照组,差异有统计学意义(P<0.05)。实验组第一产程(516.43±77.61)min、第二产程(66.54±8.36)min均显著短于对照组的(660.67±105.73)、(94.73±16.35)min,差异有统计学意义(P<0.05)。实验组发生新生儿窒息1例,出生5 min新生儿Apgar评分(9.34±0.41)分;对照组发生新生儿窒息6例,出生5 min新生儿Apgar评分(8.83±0.38)分。实验组新生儿窒息发生率及出生5 min新生儿Apgar评分均优于对照组,差异有统计学意义(P<0.05)。实验组新生儿发生脊柱受损1例,颅骨骨折2例,头皮产伤0例;对照组新生儿发生脊柱受损5例,颅骨骨折3例,头皮产伤2例。实验组新生儿产伤总发生率低于对照组,差异有统计学意义(P<0.05)。结论对枕横位和枕后位难产产妇进行徒手旋转胎头术,有利于矫正胎头位异常情况,便于产妇顺利进行分娩,减少产妇时长,值得在临床推广。Objective To analyze the clinical value of freehand rotation of the fetal head in the treatment of dystocia in occipital transverse position and occipital posterior position.Methods A total of 64 women with dystocia in occipital transverse position and occipital posterior position were studied and divided into experimental group and control group according to random lottery method,with 32 cases in each group.The control group received conventional delivery mode,and the experimental group received freehand rotation of the fetal head.The natural delivery,the occurrence of postpartum infection,the length of labor,the condition of the newborn and the neonatal injury in the two groups were compared.Results In the experimental group,there were 29 cases of natural delivery and 3 cases of postpartum infection;in the control group,there were 22 cases of natural delivery and 11 cases of postpartum infection.The natural delivery rate and incidence of postpartum infection in the experimental group was significantly better than that in the control group,the difference was statistically significant(P<0.05).The first stage of labor in the experimental group was(516.43±77.61)min and the second stage of labor was(66.54±8.36)min,which were significantly shorter than those of(660.67±105.73)and(94.73±16.35)min in the control group,and the differences were statistically significant(P<0.05).The experimental group had 1 case of neonatal asphyxia,and the neonatal Apgar score at 5 min after birth was(9.34±0.41)points;the control group had 6 cases of neonatal asphyxia,and the neonatal Apgar score at 5 min after birth was(8.83±0.38)points.The incidence of neonatal asphyxia and Apgar score at 5 min after birth in the experimental group were better than those in the control group,and the differences were statistically significant(P<0.05).The experimental group had 1 case of spinal injury,2 cases of skull fracture and 0 case of scalp birth injury;the control group had 5 cases of spinal injury,3 cases of skull fracture and 2 cases of sca

关 键 词：徒手旋转胎头术 枕横位 枕后位 难产 

分 类 号：R714.44[医药卫生—妇产科学]