阴道手术助产对围产结局的影响  

The influence of operative vaginal delivery on perinatal outcome

作　　者：魏团君 孙培焱 赵红阳 陈莹莹 常鑫媛 原子莉 韩宁[1] Wei Tuanjun;Sun Peiyan;Zhao Hongyang;Chen Yingying;Chang Xinyuan;Yuan Zili;Han Ning(Department of Obstetrics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院产科,郑州450052

出　　处：《河南外科学杂志》2023年第5期29-33,共5页Henan Journal of Surgery

基　　金：河南省科技攻关计划联合共建项目(LHGJ20210460)。

摘　　要：目的探讨第二产程中阴道手术助产对围产结局的影响。方法回顾性分析2017-01—2021-12于郑州大学第三附属医院产房分娩的1150例孕产妇的临床资料,按照第二产程有无手术助产分为研究组(产钳组116例、胎吸组505例)和对照组(529例)。分析3组孕产妇的分娩情况及母儿并发症,探讨围产结局的差异性。结果研究组的孕次更小,经产妇比例更低,分娩镇痛率、会阴侧切率,产后出血、急性绒毛膜羊膜炎、重度会阴裂伤、尿潴留、羊水污染的发生率更高,第二产程时长更长,产后出血量更多,新生儿并发症发生率更高。差异均有统计学意义(P<0.05)。与胎吸组比较,产钳组第二产程时长更长、产后出血量更多,急性绒毛膜羊膜炎、重度会阴裂伤及尿潴留的发生率,以及颜面部夹痕率、面神经损伤率更高,新生儿头皮血肿率更低。差异均有统计学意义(P<0.05)。胎吸组的新生儿颅内血肿率、新生儿窒息率高于产钳组,转新生儿科率及助产成功率低于产钳组,但差异无统计学意义(P>0.05)。结论阴道手术助产是解决第二产程头位难产的重要方式,产钳与胎吸各有优势,合理应用可改善围产结局。Objective To investigate the effect of operative vaginal delivery on perinatal outcomes during the second stage of labor.Methods Retrospective analysis was performed on the clinical data of 1150 pregnant women who delivered in the delivery room of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2021.According to the presence or non-presence of surgical midwifing during the second stage of labor,they were divided into study group(n=621)and control group(n=529).The study group was divided into forceps group(n=116)and fetal suction group(n=505).The delivery conditions and maternal and infant complications such as severe perineal laceration,postpartum hemorrhage,urinary retention,neonatal asphyxia,neonatal injury of the three groups were analyzed to explore the differences in perinatal outcomes.Results Compared with the control group,the number of pregnancies in the study group was smaller,the proportion of parturients was lower,the rate of labor analgesia,the rate of lateral perineal incision,postpartum hemorrhage,acute chorioamnitis,severe perineal laceration,urinary retention,amniotic fluid pollution was higher,the second stage of labor was longer,postpartum bleeding was more,and the incidence of neonatal complications was higher(P<0.05).Compared with the fetal aspiration group,the duration of second labor and postpartum blood loss in the forceps group were larger,the incidence of acute chorioamnitis,severe perineal laceration and urinary retention was higher,the rate of facial pinch marks and facial nerve injury was higher,and the rate of neonatal scalp hematoma was lower,with statistical significance(P<0.05).The rate of neonatal intracranial hematoma and neonatal asphyxia in fetal aspiration group was higher than that of forceps group,and the rate of paediatrics transfer and success rate of midwifery were lower than that of forceps group,with no statistical significance(P>0.05).Conclusion Operative vaginal delivery is an important way to solve cephalic dystocia in the second s

关 键 词：阴道手术助产 产钳 胎头吸引术 围产结局 

分 类 号：R719[医药卫生—妇产科学]