产程中实施特殊体位矫正胎方位的观察研究

Study of Correction of Occipito-Position by Special Posture Nursing during the Process of Labor

目的 :探讨产程中实施特殊体位护理矫正胎方位的临床效果。方法 :选择 37～ 42周 ,先兆临产经B超检查证实为枕后位的初产妇 6 2例为观察组。在产程中指导观察组产妇取高坡侧俯卧位、手 -膝位 ,并与以往未做体位护理组对照。结果 :观察组有 5 5例经阴道分娩 ,占 88.7% ,对照组仅 14例经阴道分娩 ,占 2 2 .6 % ;观察组剖宫产 7例 ,占 11.3% ,对照组 48例 ,占 77.4% ;两组比较 ,差异有非常显著性意义 (P <0 .0 0 1)。而且对照组比观察组产程各期明显延长 ,胎先露下降速度明显减慢 ,胎儿宫内缺氧、新生儿窒息率明显增加 ,两组差异有非常显著性意义 (P <0 .0 1)。结论 :产程中实施特殊体位护理可以矫正胎头枕后位 ,降低难产发生率。

Objective: To investigate the clinical effect of correction of occipito-posterior (op) presentation by special posture nursing. Method: A prospective study was conducted in 62 pregnant women who were rectified occipitoposterior position by B-ultrasound in 37-42 weeks. Women in labor were instructed to take the high lateral posture and hand- knee posture. The former who were not cared by special posture were selected as controls. Result: 55 women (88.7%) delivered vaginally, and 7 women (11.3%) received cesarean section in the observation group. Only 14 women (22.6%) delivered vaginally, and 48 women ( 77.4% ) had cesarean section in the control group,( P <0.01).There was significant difference betwween two groups in the average time of each stage ( P <0.001). The time interval of the observation group was obviously shorter than control group. In the control group, the foetus appeared earlier but delivered slowlier, and the rate of lack of Oxygen in the womb and asphyxia of babies obviously increased. Conclusion: It was an effective method for the mother to take the special posture nursing for correcting the OP position. The incidence of dystocia may be reduced as well as the cesarean section rate. The method was simple and effective, and can be used in most of hospitals.Author's address Department of Gynaecology of Zhejiang Yiwu People's Hospital,322000