徒手旋转矫正胎方位异常的临床效果

Clinical applications of circumrotating fetus head for correcting exceptional azimuth bare handed

目的研究徒手旋转矫正胎方位异常临床应用和效果。方法对产程进入活跃期后胎头方位异常156例经加强产力,改变母体体位,封闭水肿宫颈等处理,胎头方位仍不能自然转为枕前位,产程阻滞胎头方位异常施行经阴道徒手旋转胎头,辅以经孕妇腹部推胎儿背为脊前方位联合手法。结果156例经徒手旋转矫正成功118例,成功率75.6%。徒手旋转成功与头位分娩评分有相关性,即:四项综合评分高低对徒手旋转胎方位有显著影响。关键在于由枕横位2分增加到枕前位3分,枕后位1分增加到枕前位3分,使四项评分均达到10分以上,80%以上可经阴道分娩。结论徒手旋转矫正胎方位在头位难产中是必要的,它可以使难产转为顺产,对母婴有利。

Objective To evaluate the effects of circumrotating fetus head for exceptional azimuth bare-handed. Methods The combined techniques of strengthening delivery, transforming pregnant women body posture and occluding the edema cervix had been performed, however, delivery processing cumbering fetus head exceptional azimuth,fetus head not circumrotating the pillow front naturally,operators took the procedure of circumrotating fetus head bare-handed via vagina associating with pushing the fetus back to ridge front azimuth during the course of the delivery activity period for 156 cases fetus head exceptional azimuth. Results The techniques rectified 156 cases with durative fetus heads exceptional azimuth, in 118 cases obtained success（rates 75.6%）.Thc success rates of circumrotating barehanded was related to fetus heads azimuth delivery scores; the total scores reflect notability of circumrotating fetus head azimuth bare-handed. The key scores added up to 3 from 2 by transferring pillow horizontal to pillow front, and from 1 by transferring pillow back to pillow front. The 80% of patients could receive delivery via vagina if the total scores of 4 items exceed 10.Conclusion It＇s necessary for fetus head exceptional azimuth dystocia that ciroumrotating fetus head azimuth bare-handed can transform normal delivery,thus is beneficial to pregnant women and her fetus.