中心电子监护系统的临床应用

Clinical Use of Central Electronic Monitoring System

目的 探讨使用中心电子监护系统 (centralelectronicmonitoringsystem ,CEMS)对提高产科质量的作用。方法 对 1997年 11月至 1998年 3月在我院分娩的孕周≥ 3 7周的 12 16例孕妇 (监测组 )进行CEMS监护 ,并与 1996年 11月至 1997年 3月在我院分娩的孕周≥ 3 7周、未行CEMS监护的113 7例孕妇 (对照组 )进行比较 ,分析两组胎儿窘迫发生率、新生儿窒息发生率、剖宫产率和阴道手术产率。结果 对照组与监测组胎儿窘迫发生率分别为 9 8%、12 8% ;新生儿窒息发生率分别为4 8%、2 3 % ;剖宫产率和阴道手术产率分别为 3 6 3 %、3 7 8%和 4 4 %、4 4 %。结论 使用CEMS实现了分娩过程中的部分数据计算机管理 ,不增加手术产率 ,新生儿窒息率明显下降。

Objective To evaluate the effects of central electronic monitoring system (CEMS). Methods A total of 1 216 patients with ≥37 weeks of gestation assigned as monitoring group, were performed central electronic monitoring during labor from Nov. 1997 to Mar. 1998. A total of 1 137 patients with same gestational age assigned as control group, were monitored by using intermittent auscultation during labor from Nov. 1996 to Mar. 1997. The rate of fetal distress, neonatal asphyxia, cesarean section, and using of forceps or vacuum extractor in the 2 groups were compared. Results Patients in the monitoring group had a higher fetal distress rate (12.8%) than that of the control group (9.8%, P <0.05), but a significantly lower neonatal asphyxia rate (2.3%) than that of the control group (4.8%, P <0.01). There were no significant differences in the overall cesarean rate, cesarean rate for fetal distress, overall use rate of forceps or vacuum extractor delivery, and vaginal operative delivery rate for suspected fetal distress between the two groups ( P >0.05). Conclusion Quality for obstetric care was significantly improved by application of central electronic monitoring for labor management, it didn′t increase the cesarean section rate and vaginal operative delivery rate, but decreased the neonatal asphyxia rate.