新旧产程处理标准在当代孕妇产程管理中的效果分析

发布时间：2018-07-01 15:46

本文选题：新产程处理标准 + 弗里德曼产程图　；参考：《兰州大学》2017年硕士论文

【摘要】：目的:目前临床上对于分娩产程处理标准的参考尚无准确依据,对于新旧产程处理标准意见尚不统一。本研究的目的是探讨旧产程处理标准(即Friedman产程曲线)与新产程标准及专家处理共识在当代孕妇产程管理中对于合理产科干预以及母婴结局的影响。方法:本研究回顾性分析兰州大学第一医院产科病区2014年1月1日-2014年2月28日以及2016年9月1日-2016年10月31日期间收住的年轻单胎头位妊娠孕妇188例,分为对照组(n=90,采用旧产程处理标准管理产程)和研究组(n=98,采用新产程处理标准管理产程),比较分析2组孕妇分娩过程中各产程时限、所给予临床干预以及母婴结局的影响。结果:(1)两组孕妇一般情况及新生儿出生质量比较差异无统计学意义(P0.05);(2)研究组活跃期产程时间更短,两组比较差异有统计学意义(P0.05),两组在潜伏期时间、第二以及第三产程时间上无明显差异(P0.05);(3)对照组第二产程中低位产钳阴道助产例数明显多于研究组,差异有统计学意义(P0.05),两组在缩宫素使用、第二产程会阴侧切(及正中切)助娩以及第一、第二产程中干预总例数的比较上,差异均无统计学意义(P0.05);(4)对照组中转剖宫产孕妇例数明显高于研究组,差异有统计学意义(P0.05);(5)在两组母婴结局方面:研究组胎儿窘迫及产后出血例数明显少于对照组,母体产伤例数高于对照组,差异均有统计学意义(P0.05);两组间新生儿窒息差异无显著性(P0.05)。结论:新产程处理标准减少了产程管理中不必要的临床干预,有效降低了剖宫产率,让更多孕妇避免了剖宫产术带来的后续伤害。与此同时,并未明显增加在母婴结局方面对孕妇及新生儿的严重不良预后。因此,我们认为新产程处理标准在临床医师对当代孕妇分娩产程管理中值得推广。
[Abstract]:Objective: at present, there is no accurate basis for the reference of the standard of delivery process in labor, and the standards for the treatment of new and old birth process are not uniform. The purpose of this study is to discuss the old birth process standard (the Friedman production process curve) and the new birth process standard and the expert's consensus on the rational obstetric intervention in the management of the maternity process of the pregnant women. Methods: a retrospective analysis of 188 young single pregnant women with single pregnancy in the Department of Obstetrics, First Hospital Affiliated to Lanzhou University, February 28th -2014 January 1, 2014 and October 31st September 1, 2016 -2016, was divided into the control group (n=90, the standard management of the old labor process) and the study group (n=98, mining group). With the standard management of birth process with the new birth process, the results were compared and analyzed between the 2 groups of pregnant women during childbirth, the clinical intervention and the effect of maternal and infant outcome. Results: (1) there was no significant difference between the general conditions of the two groups and the birth quality of the newborn (P0.05); (2) the time of the study group was shorter in the active stage and the two groups were different. Statistical significance (P0.05), there was no significant difference between the two groups in the latency time, second and third period of labor (P0.05); (3) the number of vaginal midwifery in the middle and low position forceps in the second stage of the control group was significantly more than that of the study group (P0.05), the two groups were used in the oxytocin, the second stage of the perineum side cut (and median cut) was assisted and the first, There was no significant difference in the total number of intervention in the second stage of labor (P0.05); (4) the number of pregnant women in the control group was significantly higher than the study group, the difference was statistically significant (P0.05); (5) in the two groups of maternal and infant outcomes, the number of fetal distress and postpartum hemorrhage in the study group was significantly less than that of the control group, and the number of maternal injury cases was higher than that of the control group. The difference was statistically significant (P0.05); there was no significant difference in neonatal asphyxia between the two groups. Conclusion: the new birth process management standard reduces the unnecessary clinical intervention in the management of labor process, effectively reduces the rate of caesarean section and prevents more pregnant women from the subsequent injury caused by cesarean section. At the same time, it does not increase the maternal and infant outcome. In view of the serious adverse prognosis of pregnant women and newborns, we believe that the standard of new labor treatment is worth promoting by clinicians in the delivery management of contemporary pregnant women.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714

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