头位难产中产钳助产术应用变迁

The alternation of application of obstetrics forceps in dystocia of vertex presentation

目的 :探讨头位难产中产钳助产术的应用变迁 ,指导临床正确使用产钳助产术。方法 :对我院 1995年 1月至 1999年 12月间头位难产 991例的临床资料进行回顾性分析。结果 :在头位难产处理中 ,剖宫产率呈逐年升高趋势 ,产钳助产率则呈下降趋势。剖宫产术与低位、出口产钳术致产后出血及新生儿窒息方面无显著性差异 (P >0 .0 5 ) ,中位产钳较低位及出口产钳对母、儿损伤大 (P <0 .0 5 )。 结论 :低位及出口产钳术在难产处理中仍具有应用价值。难度较大的中 (高 )位产钳术应由剖宫产术取代。正确掌握产钳助产条件及操作 ,对提高产科质量具有积极的影响。

Objective: We analyzed the alternation of application of obstetrics forceps in recent five years in our hospital in order to direct correct clinical application of obstetrics forceps. Method: 991 cases of dystocia of vertex presentation in our hospital from January 1995 to December 1999 were reviewed. Results: Among dealing with the dystocia of vertex presentation, the rate of cesarean section tends to increase and the rate of forceps delivery tends to decrease year by year. There was no difference of postpartum hermorrhage and neonatal asphyxia between cesarean section and forceps delivery of low and base location (P>0.05). Forceps delivery of middle location had more trauma to mater and neonate than that of low and base location. Conclusion: Forceps delivery of low and base location on dealing with dystocia is worth of clinical popularization.Forceps delivery of middle location should be replaced by cesarean section. It is important to improve the qualification of obstetrics that we have to correctly master the indication and operation of forceps delivery.