产程活动车联合特殊体位在第一产程活跃期矫正枕横位临床效果观察
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摘要
目的:探讨在第一产程活跃期使用产程活动车联合特殊体位矫正枕横位的临床效果。方法:将入院时B超确诊为枕横位且符合试产条件无胎膜早破的初产妇130例,随机分为试验组和对照组。试验组在活跃期胎膜未破时予产程活动车自由行走,宫缩较强时卧床休息予胎背对侧卧位。对照组仅给予常规护理,产妇自由选择卧位。分析2组产妇的胎头转正率、分娩方式、第一产程时间、新生儿Apgar评分以及产妇分娩后的并发症发生情况。结果:在产程中,试验组由枕横位胎头转到枕前位的有60例,对照组由枕横位胎头转枕前位有41例,试验组胎头转正率高于对照组(P<0.01)。试验组自然分娩率高于对照组,剖宫产率低于对照组(P<0.01);试验组自然分娩第一产程的潜伏期和活跃期的时间均短于对照组(P<0.01),非自然分娩新生儿Apgar评分高于对照组(P<0.01),产妇产后出血量、软产道损伤率、产褥感染率均低于对照组(P<0.01)。结论:在第一产程活跃期对枕横位的孕妇实行产程活动车联合特殊体位,可以增加产妇胎头转正率、自然分娩率以及新生儿的Apgar评分,明显缩短第一产程的时间并降低产妇分娩后的并发症发生率。
Objective:To investigate the clinical effects of the mobile delivery vehicle combined with special position in correcting the transverseposition during the active period of the first stage of labor.Methods:One hundred and thirty patients with transverseposition diagnosed by B ultrasound and without premature rupture of membrane under trial condition were randomly divided into the experimental group and control group.The experimental group without rupture of membrane during active period could free walk on mobile delivery vehicle,and when the contraction was strong,the patients stayed in bed under the lateral position of the fetal back.The control group was given the routine care,and the patients were free to choose the lying position.The fetal head positive rate,delivery mode,first stage of labor,neonatal Apgar score and complications of maternal delivery were analyzed in two groups.Results:During the labor process,60 cases in experimental group were transferred from the transverse occipital fetal head to the anterior occipital position,and 41 cases in control group were transferred from the transverse occipital fetal head to the anterior occipital position,and the positive rate of which in experimental group was higher than that in control group(P<0.01).The rate of natural delivery in experimental group was higher than that in control group,and the rate of cesarean section in experimental group was lower than that in control group(P<0.01).The incubation period and active period of the first stage of natural delivery in experimental group were shorter than those in control group,the neonatal Apgar score in experimental group was higher than that in control group,and the postpartum blood loss,soft birth canal injury rate and puerperal infection rate in experimental group were lower than those in control group(P<0.01).Conclusions:During the active period of the first stage of labor,the mobile delivery vehicle combined with special position can improve the maternal fetal head rate,natural delivery rate and Apgar score of the newborn,significantly shorten the time of the first stage of labor,and reduce the incidence rate of postpartum complications.
Objective:To investigate the clinical effects of the mobile delivery vehicle combined with special position in correcting the transverseposition during the active period of the first stage of labor.Methods:One hundred and thirty patients with transverseposition diagnosed by B ultrasound and without premature rupture of membrane under trial condition were randomly divided into the experimental group and control group.The experimental group without rupture of membrane during active period could free walk on mobile delivery vehicle,and when the contraction was strong,the patients stayed in bed under the lateral position of the fetal back.The control group was given the routine care,and the patients were free to choose the lying position.The fetal head positive rate,delivery mode,first stage of labor,neonatal Apgar score and complications of maternal delivery were analyzed in two groups.Results:During the labor process,60 cases in experimental group were transferred from the transverse occipital fetal head to the anterior occipital position,and 41 cases in control group were transferred from the transverse occipital fetal head to the anterior occipital position,and the positive rate of which in experimental group was higher than that in control group(P<0.01).The rate of natural delivery in experimental group was higher than that in control group,and the rate of cesarean section in experimental group was lower than that in control group(P<0.01).The incubation period and active period of the first stage of natural delivery in experimental group were shorter than those in control group,the neonatal Apgar score in experimental group was higher than that in control group,and the postpartum blood loss,soft birth canal injury rate and puerperal infection rate in experimental group were lower than those in control group(P<0.01).Conclusions:During the active period of the first stage of labor,the mobile delivery vehicle combined with special position can improve the maternal fetal head rate,natural delivery rate and Apgar score of the newborn,significantly shorten the time of the first stage of labor,and reduce the incidence rate of postpartum complications.
引文
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[9] XING XZ,WANG HJ,QU SN,et al.The value of esophagectomy surgical apgar score (eSAS) in predicting the risk of major morbidity after open esophagectomy[J].J Thorac Dis,2016,8(7):1780.
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[11] 何玉平.阴道分娩产后出血预见性护理效果研究[J].实用临床医药杂志,2017,21(20):197.
[2] 童美和,于海微.产程中枕横位和枕后位的胎头机转临床研究[J].中国医师杂志,2015,17(11):1682.
[3] 杨玲.持续性枕横位与枕后位122例临床分析[J].蚌埠医学院学报,2011,36(7):712.
[4] 王桂梅,杨小红,胡娅萍.单绒毛膜单羊膜囊双胎之一畸形1例[J].实用医学杂志,2015,31(20):3426.
[5] 徐赛英.综合护理干预对枕横位及枕后位产妇产程和分娩结局的影响[J].中国计划生育学杂志,2016,24(3):183.
[6] 魏丽娜.探究徒手旋转胎头术对枕横位和枕后位难产的治疗效果[J].中国继续医学教育,2016,8(19):112.
[7] 兰景尤.评价影响初产妇头位难产的因素、临床表现及其临床处理对策[J].世界最新医学信息文摘,2016,16(A5):32.
[8] 赵舜枝王少娜,林晓冰.自由体位纠正枕后(横)位的效果观察[J].中国医学创新,2016,13(1):50.
[9] XING XZ,WANG HJ,QU SN,et al.The value of esophagectomy surgical apgar score (eSAS) in predicting the risk of major morbidity after open esophagectomy[J].J Thorac Dis,2016,8(7):1780.
[10] 贺利平,李晋琼,张瑛,等.不同分娩方式高危产妇产褥期感染相关因素及对新生儿的影响[J].中华医院感染学杂志,2018,28(12):1884.
[11] 何玉平.阴道分娩产后出血预见性护理效果研究[J].实用临床医药杂志,2017,21(20):197.