胎头吸引器和产钳助产在阴道分娩中的应用

发布时间：2018-05-13 11:29

本文选题：胎头吸引器 + 产钳　；参考：《中山大学学报(医学科学版)》2017年03期

【摘要】：【目的】比较胎头吸引器和产钳阴道助产的分娩结局。【方法】收集我院规律产检并分娩的孕妇164例,其中使用胎头吸引器的82例作为吸引器组,使用低位和出口产钳的82例作为产钳组,使用阴道助产前胎位为枕横位或枕后位者为胎位异常组。比较分析吸引器组和产钳组的母婴并发症。【结果】产钳组阴道裂伤率明显高于吸引器组(56.1%vs 24.2%,P0.01),但新生儿头皮血肿和新生儿高胆红素血症(NHB)的发生率低于吸引器组(P0.05);产钳胎位异常组的阴道裂伤率也高于吸引器胎位异常组(76.5%vs.22.2%,P0.05),但新生儿高胆红素血症的发生率低于吸引器胎位异常组(P0.05)。决策到分娩的时间间隔、产后24 h出血量、产后24 h白细胞和中性粒值、新生儿窒息率、颅内出血、帽状腱膜下出血、新生儿转科率及新生儿缺血缺氧性脑病(HIE),吸引器组和产钳组两组间比较差异均无统计学意义(P0.05)。【结论】胎头吸引器阴道助产会降低阴道的裂伤率,尤其是胎位异常时的阴道裂伤率,但增加新生儿头皮血肿和NHB的发生。
[Abstract]:[objective] to compare the delivery outcome of fetal head attractor and vaginal delivery by forceps. [methods] 164 pregnant women with regular birth examination and delivery were collected, 82 of them were used as suction group. 82 cases of low and outlet forceps were used as forceps, and the abnormal position of occipital position or occipital posterior position was used before vaginal midwifery. [results] the rate of vaginal laceration in the forceps group was significantly higher than that in the suction group (56.1 vs 24.2P 0.01), but the incidence of neonatal scalp hematoma and neonatal hyperbilirubinemia was lower than that in the suction group. The rate of vaginal laceration in the group with abnormal fetal position of the forceps was also higher than that in the group with abnormal fetal position of the attractor, but the incidence of hyperbilirubinemia in the newborn was lower than that in the group with abnormal fetal position of the attractor (P 0.05), but the incidence of hyperbilirubinemia in the newborn was lower than that in the group with abnormal fetal position. The interval between decision and delivery, the amount of blood lost 24 hours after delivery, the leukocyte and neutrophil values of 24 hours postpartum, the rate of neonatal asphyxia, intracranial hemorrhage and subaponeurotic hemorrhage. There was no significant difference between the two groups (P 0.05). [conclusion] the rate of vaginal delivery with fetal head attractor can reduce the rate of laceration of vagina. Especially the rate of vaginal laceration in abnormal fetal position, but increased the occurrence of neonatal scalp hematoma and NHB.
【作者单位】：中山大学附属第三医院产科;
【基金】：广东省科技计划项目(2011B061300030)
【分类号】：R714.3

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