体位纠正联合麻醉镇痛矫正枕后位的效果观察

Observation on the effect of correcting posture combining anesthesia analgesia in rectifying occiput posterior position

目的：探讨体位纠正联合麻醉镇痛矫正枕后位的临床效果。方法选择进入临产的单胎头位初产妇80例，宫口开大2～3cm，经阴道或B超检查确认为枕后位。随机将其分为两组：观察组40例，实施麻醉镇痛并在产程中进行特殊体位矫正胎方位；对照组40例，未实施麻醉镇痛，自由体位，对两组的治疗效果进行比较分析。结果观察组未见发生新生儿窒息病例，而对照组有4例，占10．0％。观察组胎方位改变、自然分娩率高于对照组（χ^2值分别为4．381和5．950，均P＜0．05），而胎儿宫内窘迫发生率明显低于对照组（χ^2＝0．933，P＜0．05）。结论产程中体位纠正联合麻醉镇痛能及时矫正胎儿枕后位，提高阴道自然分娩率，降低剖宫产率。

Objective To explore the clinical results of correcting posture combining anesthesia analgesia in rectifying occiput posterior position.Methods Eighty primiparas with single head position to labor were selected, and their cervixs were open about 2-3cm.Their fetus were confirmed as occiput posterior position by vaginal or B ultrasonic examination.All cases were randomly divided into two groups with 40 in each.Observation group accepted anesthesia analgesia and special fetal positions correcting in labor, while control group did not receive anesthesia analgesia and had free posture.Results In observation group, there was no neonatal asphyxia case, while 4 cases were found in the control group, accounting for 10.0%.Changes in fetal position was much and the natural birth rate was higher in the observation group than in the control group （χ2 value was 4.381 and 5.950, respectively, both P〈0.05）, but the incidence of fetal distress was significantly lower than the control group （χ2 =0.933,P ＆lt;0.05）.Conclusion In labor position correcting combining anesthesia analgesic can timely rectify occiput posterior position, improve vaginal birth rate and reduce cesarean rate.