子宫下段按压联合子宫底按摩用于改善第三产程时间及产后出血的临床观察  

Clinical observation of the lower uterine segment pressing combined with uterine bottom massage for improving the duration of the third stage of labor and the postpartum hemorrhage

作　　者：高丽娟 罗凤梅[1] 魏素花[1] 王利娟 GAO Lijuan;LUO Fengmei;WEI Suhua;WANG Lijuan(Center for Obstetrics and Gynecology,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing,Jiangsu Province,210008)

机构地区：[1]南京大学医学院附属鼓楼医院妇产医学中心,210008

出　　处：《中国计划生育学杂志》2023年第10期2495-2498,共4页Chinese Journal of Family Planning

基　　金：南京鼓楼医院新技术发展基金(XJSFZJJ202037)。

摘　　要：目的:探讨第三产程按压子宫下段联合按摩子宫底用于改善第三产程时间及产后出血的临床效果。方法:2022年4-10月于本院阴道分娩的260例产妇随机分为对照组、观察组各130例。对照组在第三产程时常规使用缩宫素,出现胎盘剥离征象后协助胎盘娩出;观察组在胎儿娩出后立即按压子宫下段联合按摩子宫底,同时常规使用缩宫素,出现胎盘剥离征象后协助胎盘娩出。观察两组第三产程时间及产后出血情况。结果:两组产妇胎盘娩出方式及产后严重出血率均无统计学意义(P>0.05)。观察组产妇的第三产程时间[M(P25,P75)]为3(2,5)min,短于对照组的5(4,7)min(Z=6.19,P<0.05)。观察组产时、产后2 h、产后24 h出血量分别为[200(100,285)ml]、[50(40,80)]ml、[290(213.5,386.3)]ml,均低于对照组的[200(125,300)]ml、[60(45,90)]ml、[325(237.5,457.5)]ml(Z=2.50、2.17、2.22,P<0.05),产后出血率为9.2%,低于对照组的18.5%(χ^(2)=4.463,P<0.05)。结论:第三产程按压子宫下段联合按摩子宫底能有效缩短第三产程时间,减少产时、产后2 h及24 h出血量,降低产后出血率,值得临床应用。Objective:To investigate theclinical effectof theloweruterine segment pressing combined with uterine bottom massage for improving the duration of the third stage of labor and the postpartum hemorrhage.Methods:260women who wanted vaginal delivery were randomly divided into two groups(130 cases in each group)from April to October 2022.The women in the control group were given routinely pitocin during the third stage of labor,and thengiven assisted in the delivery of the placenta after signs of placental abruption appeared.The women in the observationgroup were given the lower uterine segment pressing immediately after the delivery of the fetus and routinely pitocin,and thengiven assisted in thedeliveryoftheplacenta aftersignsof placental abruption appeared.The duration of the third stage of labor and the postpartum hemorrhage situation of the women in both groups were observed.Results:There were no statistical significance differences in the mode of placenta delivery and the rate of severe postpartum hemorrhage of the women between the two groups(P>0.05).The duration[M(P25,P75)]of the third stage of la-borof the women in the observationgroup was[3(2,5)min],which was significantly shorter than that 5(4.7)min ofthe women in the control group(Z=6.19,P<0.05).The blood loss of the women in the observation group during de-liveryand at2hand24h after deliverywere[200(100,285)ml,50(40,80)ml,290(213.5,386.3)ml,respectively,and which were all signific antly lower than those 200(12500)ml,60(4590)mland325(237.5457.5)mlresptively]of the women in the control group(Z-2.50,2.172.22P<0.05).The postpartum hemorrhagerate(9.2%)of the women in the observation group was significantly lower than that(18.5%)of the women in the control group(x=4.463,P<0.05).Conclusion:The lower uterine segment pressing combined with uterine bottom massage fortreating the women can effectively shorten their duration of the third stage of labor,can reduce their amount of the in-trapartum and postpartum bleeding at 2 h and 24 h,and can reduce their rate of pos

关 键 词：阴道分娩 第三产程 按摩子宫 产后出血 

分 类 号：R714.461[医药卫生—妇产科学]