徒手转胎纠正128 例头位难产的临床效果观察

目的:探讨应用徒手转胎术纠正头位难产的临床效果,为提高经阴道分娩的成功率提供参考。方法:选取2014年6月-2015年12月我院收治的128例头位难产患者作为研究对象,随机为研究组和对照组,每组64例。对照组在第二产程初期采用胎头吸引术,研究组患者通过徒手旋转胎头术调整胎头方位。观察并比较两组产后出血量、第二产程时间及新生儿神经行为测定(NBNA)评分。结果:研究组患者阴道自然分娩成功率(95.31%)高于对照组(73.44%),差异有统计学意义(P0.05);研究组产后出血量和第二产程时间均显著低于对照组,差异具有统计学意义(P0.05);研究组新生儿NBNA评分高于对照组,但两组之间比较,差异无统计学意义(P0.05)。结论:徒手转胎术与胎头吸引术两种干预方式对新生儿行为神经的影响无明显区别,但徒手转胎术可以有效缩短头位难产产妇的产程,并能显著提高阴道分娩率,有益于母婴的预后,值得临床推广应用。

Clinical Observation of 128 Cases of the Application of Manual Rotation of the Head Difficult

Objective:To explore the application of manual rotation of fetal surgery to correct head dystocia, in order to provide areference to improve the success rate of vaginal delivery.Methods:128 cases with head and labor in our hospital from June 2014 to December2015 were selected as the research objects, and randomly divided into the the study group and the control group, with 64 cases ineach group. The patients in the control group were treated with fetal head aspiration at the beginning of the second stage of labor, whilethe patients in the study group were treated with manual rotation of position adjustment. Then the amount of postpartum hemorrhage,time of the second stage of labor and neonatal neurobehavioral score (NBNA) in the two groups were observed and compared.Results:The success rate of vaginal delivery in the experimental group was 95.31%, which was much higher than 73.44% of the control group,and the difference was statistically significant (P<0.05); The postpartum hemorrhage volume and the second stage of labor in the studygroup were lower than those of the control group, and the differences were statistically significant (P<0.05); The total score of NBNA inthe experimental group was slightly higher than that of the control group, while the difference between the two groups was not significant(P>0.05).Conclusion:There is no obvious difference between the two kinds of effects of the manual transfer and fetal head aspiration.However, the manual transfer can shorten the labor process of the head, and can improve the vaginal delivery rate, which is beneficial tothe maternal and infant prognosis, which is worthy of clinical application.