产钳助产与剖宫产对新生儿颅脑损伤的对比临床研究

目的 对比剖宫产及产钳助产的新生儿神经系统并发症的发生率.方法 收集2010年1月至2014年1月≥37周的单胎正常初产妇,产钳助产阴道分娩628例,剖宫产1992例,新生儿脑颅硬膜下出血、脑室内出血、癫痫、头皮裂伤或血肿、颅骨骨折、面神经麻痹、臂丛神经损伤中的任意一诊断均有效.采用单因素logistic回归分析探讨分娩方式与新生儿发病率的关系.结果 产钳助产阴道分娩组（观察组）新生儿癫痫及发生率明显小于剖宫产组（对照组）,对照组新生儿硬膜下出血发生率小于观察组.结论 可导致远期神经系统并发症的新生儿颅脑损伤在产钳助产阴道分娩中低于剖宫产,应大力推广阴道分娩,降低剖宫产率.

Objective To compare neonatal neurologic complication rates of cesarean deliveries, forceps-assisted vaginal deliveries. Methods Data on singleton live births at 37 weeks or greater gestation born to nulliparouswomen from 2010.1 to 2014.1 in The central of women and children Hospital, Chengdu.628 cases were forceps-assisted vaginal delivery and 1992 cases were cesarean delivery. Any diagnosis of neonatal subdural hemorrhage, intraventricular hemorrhage, seizures, scalp lacerationor cephalohematoma, fracture, facial nerve palsy, brachial plexus injury was considered significant. Single factor logistic regression was used to estimateassociations between delivery mode and these neonatal morbidities. Results Neonatal seizures were less in forceps-assisted vaginal delivery group and Cesarean deliveries were linked to less subdural hemorrhages compared with foreeps-assisted vaginal deliveries. Conclusion Compared with cesarean delivery, forceps-assisted vaginal delivery is associated with a reduced risk of adverse neonatal neurologicoutcomes. Cesarean delivery shoud be reduced and vaginal delivery shoud be encouraged.