94例头位剖宫产术中出头困难因素分析与对策

The Difficult Factors of Delivery Fetal Head and Countermeasure in 94 Patients Cesarean with Cephalic Presentation

目的探讨头位剖宫产术中出头困难的因素及相应对策。方法回顾性分析头位剖宫产术中94例出头困难的孕产妇资料,对这些孕产妇的术中、术后及新生儿情况,与同期头位剖宫产997例进行比较。结果与对照组比较,剖宫产术中94例出头困难的孕产妇在剖宫产史、体重、胎头高浮、巨大胎儿、麻醉满意程度、腹壁切口等方面差异有显著性,P<0.05;在手术方式、胎头深嵌、术者与助手配合不协调等方面,差异有极显著性,P<0.01。结论术中出头困难与多种因素有关,尤其与麻醉效果、胎头位置、腹壁切口、手术方式、胎儿体重、孕妇体重、术者与助手配合是否协调等情况有关。满意的麻醉、合适的腹壁切口和手术方式、熟练的手术操作技巧、术者与助手配合协调是解决出头困难的有效对策。

Objective:To study the difficult factors and countermeasure of delivery of fetal head in cephalic presentation cesarean. Method:From January 2004 to October of 2004, our hospital 94 patients with difficult delivery of fetal head and synchronization 997 patients with cephalic presentation cesarean were retrospectivly analyzed,comparison of operation,post-operation and natal of these pregnant women.Result:History of cesarean,body weight,obesity depth of abdominal fat wall,the fetal head high float,fetal macrosomia ,the anesthesia satisfaction degree,incisions between the two group have significant difference,P<0.05.It has very significant difference in the surgical operation method,Fetal head deep embed in pelvic and incoordination opertor and assistant P<0.01.Conclusion:Difficult of delivery fetal head in cesarean is relevant various factors,particularly with the anesthesia effect,the position of head fetal,wall incision,surgical operation method,weight of fetus,pregnant woman's weight,opertor and assistant whether coordination.To adopt satisfied anesthesia effect,the fit abdominal wall incision,surgical operation method,the well-trained surgical operation techniques,opertor matches with assistant coordination is valid countermeasure that solves the difficult of delivery fetal head in cesarean.