“四肢着床”(趴位)操作法处理肩难产的临床应用观察

"Limbs implantation"(lying position) operating treatment of clinical observation of shoulder dystocia

目的:探讨"四肢着床"(趴位)操作法处理肩难产的疗效。方法:回顾性分析自2008年1月至2010年4月于我院经阴道分娩因"巨大儿"发生肩难产5例患者的临床资料。结果:均在第二产程因"巨大儿"发生肩难产,应用McRobert操作法加耻骨上加压失败后,改用"四肢着床"(趴位)操作法安全、快速地将胎儿娩出,其中2例新生儿发生重度窒息,经有效的新生儿心肺复苏治疗后,新生儿均能恢复自主呼吸,Apgar评分10分。2例新生儿发现臂丛神经麻痹,未发现锁骨或肱骨骨折等并发症。结论:"四肢着床"(趴位)操作法是处理肩难产的安全、快速而有效的操作法。

Objective：Investigating the efficacy of＂limbs implantation＂on the treatment of shoulder dystocia.Method：Retrospective analysis of clinical data of shoulder dystocia because of vaginal delivery＂great child＂occurred in three patients from January 2008 to July 2009 in our hospital. Results：shoulder dystocia occurs in the second stage because of the ＂great child＂,Application McRobert operation after the failure of added pressure on the pubic bone,Switching to ＂limbs implantation＂（lying position） operation method is safe,the baby is delivered quickly,2 cases have severe neonatal asphyxia.But after the effective treatment of neonatal resuscitation,neonatal are able to resume spontaneous breathing,Apgar score is 10 points.no brachial plexus palsy or the humerus and clavicle fracture complications are found.Conclusion：＂limbs implantation＂（lying position） is safe,fast and effective operation to deal with shoulder dystocia.