剖宫产时不同胎方位使用产钳助娩的效果分析

The effection of using obstetric forceps in different fetal position to help delivery of the cesarean section

目的探讨剖宫产时选择不同胎方位上钳对使用产钳助娩胎头的影响及指导临床实践。方法对134例诊断胎头高浮、剖宫产时可能娩头困难的足月妊娠患者,使用剖宫产产钳助娩,随机分为A、B两组,A组以枕横位第一次上钳,B组以枕前位第一次上钳,比较两组的剖宫产情况及新生儿出生情况并分析结果。结果对胎头高浮患者使用剖宫产产钳助娩时,A组的胎头娩出时间、第一次上钳滑脱率均低于B组,差异有统计学意义(P<0.05);而新生儿Apgar评分、新生儿颜面损伤、产后出血、切口延裂等情况A、B两组之间差异无显著性(P>0.05)。结论对胎头高浮患者、可能娩头困难时使用剖宫产产钳助娩,枕横位更易上钳成功且节约胎头娩出时间,对新生儿、产后出血及切口延裂的影响与枕前位上钳无差异。

Objective To study of different fetal position on the use of obstetric forceps to help deliver） of fetal head in cesarean section,to guide clinical practice. Methods 134 patients with diagnosis of high - floating fetal head when the cesarean delivery may be difficult for full - term pregnancy, obstetric foreep used to help delirery time, were randomly divided in to A,B groups, A group Occipitotransverse for the first time on the forceps, B group the first time on the anterior fnreeps,and groups were compared and analyzed the results of cesarean section and birth. Results Patients with high fetal head floating ou the use of cesarean section deliver） when the nliscarriage to help forceps,A group of fetal head disengagement time for the first time on the pliers slip rate lower than the B group,the difference was significant （ P 〈 O. 05 ） ; and between A, B group Apgar score of newborns,neonatal facial injury, postpartum hemorrhage, crack, etc. extended incision was no significant difference, the difference was not statistically significant （P 〉 O. 05）. Conclusion Floating on the fetal head high cesarean section in pa tients with head and possible delivery problems to help the use of forceps delivery,Occipitotransverse on the torceps more successful and save the fetal head disengagement time,and the anterior on the forceps no difterent e for the newborn, postpartum hemorrhage,and cut the impact of crack extension.