应用羊水置换术治疗产时羊水Ⅱ、Ⅲ度胎粪污染

Effect of Amnioinfusion on Labor Complicated by Moderate or Severe Meconium-stained Amniotic Fluid

目的 :研究产时应用羊水置换技术对治疗羊水Ⅱ、Ⅲ度胎粪污染的疗效。方法 :选择产时羊水Ⅱ、Ⅲ度胎粪污染的足月单胎头位分娩孕妇 88例 ,其中的 4 4例进行羊水置换术的作为研究组 (A组 ) ;未进行羊水置换操作的另外 4 4例作为对照组 (B组 ) ;另选羊水无胎粪污染的 4 4例孕妇作为实验研究的空白对照组 (C组 )。观察其VD波缓解率、剖宫产率、新生儿血气分析及Apgar评分。结果 :A组变异减速 (VD)波的缓解率高于B组 (6 4.0 0 % ,2 9.17% ,P <0 .0 5 ) ;A组新生儿出生后 1分钟的脐血血气的pH值较B组高 (P <0 .0 5 ) ;A组的剖宫产率 (45 .4 5 % )低于B组(6 8.18% )。结论 :羊水置换对产时羊水Ⅱ、Ⅲ度胎粪污染有显著的疗效 ,可以明显改善新生儿的酸中毒与预后 ,且可以降低剖宫产率。

Objective: To study the effect of amnioinfusion (AI) on labor complicated by moderate or severe meconium-stained amniotic fluid. Methods: 88 delivery women complicated by moderate or severe meconium-stained amniotic fluid were chosen, with the consent, 44 women were treated with AI (Group A), while the other 44 cases received common treatment only (Group B). Another 44 delivery women with clear amniotic fluid were chosen as control group (Group C), which obtained no any treatment. Results: The remission rate of VD was higher in Group A than that of Group B (64.0%, 29.17%, P<0.05). In umbilical venous blood gas analysis of newborns at 1 minute after birth, the PH values in Group A were significantly higher than those in Group B(P<0.05). The cesarean section rate of Group A (45.15%) was lower than that in Group B (45.15%). Conclusions: AI has an improving effect on the anoxia status and outcome of newborns in gravidas with moderate or severe meconium-stained amniotic fluid, and decreases the cesarean section rate.