改良式托取胎头法在头位剖宫产术中胎头高浮的应用效果分析  

Application Effect of Modified Method of Lifting Fetal Head in Cephalic Caesarean Section

作　　者：戴丽萍 周佳丽 曾黎贞 杨杭 DAI Liping;ZHOU Jiali;ZENG Lizhen;YANG Hang(Department of Women's Health,Putian Maternal and Child Health Hospital,Putian,Fujian Province,351100 China)

机构地区：[1]莆田市妇幼保健院妇女保健科,福建莆田351100

出　　处：《中外医疗》2023年第14期45-48,62,共5页China & Foreign Medical Treatment

摘　　要：目的探讨在头位剖宫产手术中对出现胎头高浮的产妇应用改良式托取胎头法(improved method of holding fetal head,IMHFH)的效果。方法随机选择2019年10月—2021年3月在莆田市妇幼保健院行剖宫产手术且手术过程中出现胎头高浮的100例产妇作为研究对象,采用随机数表法分为两组,对照组50例应用手入宫腔取胎头法,观察组50例使用IMHFH,记录两组产妇治疗后子宫切口出现撕裂的情况、术中出血量、胎头娩出时间、产褥期并发症的发生情况,新生儿出生1 min后,5 min后,10 min后的Apgar评分及术后24 h的疼痛程度。结果观察组子宫切口撕裂的情况明显少于对照组,术中出血量明显少于对照组,胎头娩出时间短于对照组,差异有统计学意义(P<0.05)。观察组产褥期总并发症发生率为4.00%,明显低于对照组26.00%,差异有统计学意义(χ^(2)=9.490,P=0.002)。观察组新生儿出生1 min后,5 min后,10 min后的Apgar评分均明显高于对照组,差异有统计学意义(P<0.05)。观察组产妇治疗后24 h VAS评分明显低于对照组,差异有统计学意义(t=63.180,P<0.001)。结论对头位剖宫产手术中出现胎位高浮的产妇应用IMHFH可以有效改善产妇术后出现子宫切口撕裂的情况,降低术中出血量,减短胎头娩出的时间,降低产褥期并发症的发生率,新生儿出生后窒息出现情况减少。Objective To investigate the effect of modified fetal head lifting method(IMHFH)in parturients with high fetal head floating during cephalic caesarean section.Methods A total of one hundred women who underwent cesarean section and had high floating of the fetal head during the operation in Putian Maternal and Child Health Hospital from October 2019 to March 2021 were randomly selected as the study subjects.The method of random number table was used to divide patients into two groups.The control group(50 cases)used the method of manual intrauterine head extraction,and the observation group(50 cases)used IM HFH.The conditions of uterine incision tear,intraoperative blood loss,time of fetal head delivery,occurrence of puerperal complications,Apgar score 1 min,5 min,10 min after birth,and VAS of 24 h after treatment were recorded in the two groups.Results The uterine incision tearing in the observation group was significantly lower than that in the control group,the amount of intraoperative blood loss was significantly less than that in the control group,and the time of fetal head delivery was shorter than that in the control group,and the difference was statistically significant(P<0.05).The incidence of puerperal complications in the observation group was 4.00%,which was significantly lower than that of control group(26.00%),and the difference was statistically significant(χ^(2)=9.490,P=0.002).Apgar score at 1 min,5 min and 10 min after birth in the observation group was significantly higher than those in control group,the difference was statistically significant(P<0.05).The VAS score of 24 h after treatment in the observation group was significantly lower than that in the control group,the difference was statistically significant(t=63.180,P<0.001).Conclusion The application of IMHFH can effectively improve the situation of uterine incision tear after obstetrics and gynecology,reduce intraoperative blood loss,shorten the time of fetal head delivery,reduce the incidence of complications during puerperal period,and r

关 键 词：改良式托取胎头法 头位剖宫产术 胎头高浮 产褥期并发症 

分 类 号：R4[医药卫生—临床医学]