屈髋抱大腿法联合自主式屏气在初产妇第二产程中的应用

Hip flexion with thigh-up combined with self-breathholding during second stage of labor

目的探讨屈髋抱大腿法联合自主式屏气在初产妇第二产程中的应用效果。方法随机抽取200例初产妇，实验组100例在第二产程使用屈髋抱大腿法联合自主式屏气，对照组100例在第二产程使用传统的分娩体位和屏气用力方法，比较两组第二产程时间，产后出血量，新生儿apgar评分。结果屈髋抱大腿法联合自主式屏气应用在初产妇第二产程比对照组平均缩短28．75min，产后2小时出血量平均减少45ml，实验组新生儿窒息3例，而对照组新生儿窒息11例，其中重度窒息2例。结论屈髋抱大腿法联合自主式屏气既改变了骨产道因素，又改变了屏气用力方法，并且改善了产妇紧张、恐惧等精神因素，从而缩短第二产程时间，减少产后出血及新生儿窒息，具有临床可行性和实用性。

Objective To explore the effect of hip flexion with thigh-up combined with selfbreathholding during second stage of labor. Methods 200 primiparas were randomly assigned to receive hip flexion with thigh-up combined with self-breathholding during second stage of labor （ 100 primiparas, study group ） or conventional labor position and breathholding method （ 100 primiparas, control group ）. The duration of the second stage, volume of postpartum bleeding, and Apgar＇ s scores for neonates were compared. Results The duration of the second stage was shortened by 28.75 min and 2-hour volume of bleeding was reduced by 45ml in the study group. Neonatal asphyxia occurred in 3 newborns in the study group but 12 in the control group. Conclusions Hip flexion with thigh-up combined with selfbreathholding changes the factors of bony birth obstetric canal and the way of breathholding, improves nervousness and fear in primiparas, thus shortening the duration of the second stage and reducing postpartum bleeding and occurrence of neonatal asphyxia. It is clinically feasible and practical.