头位性难产的处理与分析

Dispose and analyze of cephalic presentation dystocia

目的：分析头住性难产的原因，探讨有效合理的处理方法。方法：回顾性分析我院自2009牟5月到2010年10月牧治的214例头位性难产患者的临床资料，总结其产生原因度预防措施。结果：所有头位异常难产患者中，持续性枕横位108例，发病率为7．57％；持续性枕后住51例，发病率为3．58％；胎头高直住15例，发病率1．05％；前不均倾位13例，发病率o．91％；额位2例，发病率0．014％；颜面位2例，发病率0．014％。分娩方式选择为，行产钳助产8例，占3．74％；儿头吸引术助产32例，占14．95％；剖宫产164例，头住难产的剖宫产率为76．63％；因枕横桩或枕后住经徒手旋转复位能自然分娩的10例，占4．67％。结论：头住难产的主要原因是胎头位置异常，其中持续性枕横住和枕后位最为常见，可以试产；但严重的胎头住异常，则需行剖宫产结束分娩。只要提高识别头位难产能力、维持较好的产力、纠正胎头位置异常以及正确进行产科处理能够有效预防头位难产，降低孕产妇及围产儿的死亡率，提高出生人口素质。

Objective To analyse the cause of cephalic presentation dystocia, this paper discusses the treatment is effective and reasonable. Methods A retrospective study from May 2009 to October 2010 drug--induced 214 cases of patients with cephalic presentation dystocia clinical information, summarize its causes and prevention measures. Results All patients with cephalic presentation dystoeia, persistent pillow horizontal position, incidence of a disease for 7.57% 108 cases; Persistent pillow a 51 cases, incidence of a disease for 3.58M ; Fetal head straight a 15 cases, the high incidence of 1.05% （n = 7） ; Pour a uneven 13 cases before, incidence of a disease 0.91%; Frontal bits 2 cases, incidence of a disease 0. 014~ ~ Facial bits 2 cases 0. 014%, morbidity. Delivery mode option for ChanQian 8 cases, line, accounting for midwifery were 3.74% ; Son head attract art, accounted for a2 cases of midwifery 14. 95% ; 164 example, head a cesarean delivery dystopia cesarean section rate for 76. 63% ; The bits or pillow for pillow by unarmed rotation after a reset can natural birth 4.67%, 10 cases were accounted for. Conclusion the head position is the main reason of the cephalic presentation dystocia, including head po- sition anomalies and bolsters the persistent pillow after a position most common, can trial--produce; But serious fetal head, you are required to do a anom- alies over cesarean section birth. As long as improve recognition dystocia ability, maintain head a better production force, correct fetal head position ob- stetric treatment correct abnormal and can effectively prevent head position during childbirth, reduce maternal and child mortality, improve surrounded birth population ouality.