产钳和吸引器助产对新生儿窒息的影响和临床应用

Clinical application of low forceps and vacuum extractor in delivering process and their effects to asphyxia of newborn

目的 评价低位产钳（Tarnier循轴产钳）和吸引器助产在产程中的应用价值和对新生儿窒息的影响。方法对我院2011年分娩的患者进行回顾性病例统计。结果二产程的妊娠结局中，产钳组、胎吸组和剖宫产组产程明显延长（P〈0．01），三组PH值与BE值均降低，与自然分娩组有统计学意义（P〈0．01）。产钳各指征中二产程停滞和胎儿窘迫患者Apgar评分和PH值均较其他指征组降低（P〈0．05），其他指征产钳组与自然分娩组无差异。结论指征恰当、技术娴熟的低位产钳和胎头吸引器助产能迅速结束分娩，减少母儿影响，不会加重新生儿窒息，有效降低了二产程的剖宫产率。

Objective To evaluate the clinical application value of the low forceps （Tarnier axis forceps） and vacuum extractor in the birth process and the influence on asphyxia of newborn. Methods Patients with delivery in our hospital in 2011 were retrospectively and statistically studied and analyzed. Results The outcome of pregnancy in the second stage of labor, birth process of obstetric forceps group, delivery by vacuum extractor group and caesarean section were significantly prolonged （compared with those of the normal group（P〈0.01）, three groups＇ pH value and BE value were decreased, there were significant statistical differences （P〈0.01）. In the three different indication groups, the Apgar score and pH value in the patients of stagnation of second stage and fetal distress were lower than those of the other indications group （P〈0.05）, there were no difference between the other indications group and natural birth group. Conclusions The skilled low forceps and vacuum extractor with appropriate indications, can end delivery quickly, reduce maternal and neonatal effects, without increasing neonatal asphyxia, and can effectively reduce the cesarean section rate in the second stage.