阴道助产术与剖宫产在足月妊娠第二产程中胎儿窘迫的临床疗效和安全性分析

The clinical efficacy and safety analysis of fetal distress of cesarean section and vaginal midwifery in the second stage of pregnancy

目的探讨分析剖宫产与阴道助产术在足月妊娠第二产程中胎儿窘迫的临床疗效和安全性。方法选择2009年10月～2012年6月期间我院产科收治的因胎儿窘迫行阴道助产术的65例孕产妇为观察组，选择其前后在第二产程巾冈胎儿窘迫行剖宫产术的65例为对照组；记录两组胎儿窘迫的原因．包括脐带因素、胎盘因素、母体因素、胎儿发育因素等，比较两种方式下胎儿窘迫的改善情况。结果观察组患者在脐带刚素和胎盘刚素的发生率分别占72.3％（47／65）和34.3％（12／65），显著高于对照组的53．8％（35／65）和17．1％（6／65），差异有统计学意义（P〈0．05）；两组患者在母体因素和胎儿发育因素的发生率分别为9．2％（6／65）、7．8％（5／651和10．8％（7／65）、6．2％（4／65），差异无统计学意义（P〉0．05）；观察组胎儿窘迫的临床症状改善率为92．3％（60／65），显著高于对照组的76．9％（50／65），差异有统计学意义（P〈0．05）。结论胎儿窘迫发生在第二产程中，应根据孕妇及胎儿的情况以及医生的熟练程度选择合适的分娩方式，及时抢救新生儿，出现胎儿窘迫时尽快结束分娩，能够较好地改善窘迫胎儿的临床症状。

Objective To investigate the clinical efficacy and safety of fetal distress of cesarean section and vaginal midwifery in the second stage of pregnancy. Methods Sixty-five cases of pregnant women due to fetal distress vaginal midwifery selected as the observation group from our hospital during the period from October 2009 to June 2012, and 65 cases were selected in the second stage of labor before and after cesarean section due to fetal distress as the control group. The umbilical cord factors, placental factors, maternal factors and fetal development factors of the two groups were recorded. The improvements of the two ways of fatal distress were compared. Results The incidence of umbilical cord factors and placental factors of the patients accounted for 72.3% （47/65） and 34.3% （12/65）, was significantly higher than 53.8%（35/65） and 17.1%（6/65） of the control group, the difference was statistically significant （P〈0.05）; the incidence of maternal factors and fetal development factors of the two groups accounted for 10.8%（7/65）,6.2%（4/65） and 9.2%（6/65）,7.8%（5/65）, the difference was not statistically significant （P〉0.05）; the fetal distress clinical improve- ment rate of the observation group was 92.3%（60/65）, was significantly higher than 76.9%（50/65） of the control group, the difference was statistically significant （P〈0.05）. Conclusion Fetal distress were occurred in the second stage and the appropriate mode of delivery should he selected due to the pregnant women and the fetus as well as the doctor＇s proficiency, we should timely rescue the newborns, and end the delivery as fast as we can. Only in this way can we im- prove the clinical symptoms of fetal distress.