妊娠期糖尿病患者无保护改良产钳助产术23例临床研究

Clinical study of 23 cases of gestational diabetes mellitus with unprotected and improved forceps midwifery

目的观察妊娠期糖尿病患者会阴无保护改良产钳助产法对母儿临床结局的影响。方法选取2014年10月~2016年9月于嘉兴市妇幼保健院采用会阴无保护改良产钳助产法终止妊娠的的23例妊娠期糖尿病产妇为研究组,取同期采用传统产钳接生法的23例妊娠期糖尿病产妇作为对照组,回顾性分析两组临床资料,比较两组产妇新生儿窒息率,产妇产后出血、会阴Ⅱ度、Ⅲ度裂伤、产后抗生素使用率、产后尿储留、产后l^2 d会阴水肿疼痛发生率、产后平均住院时间及住院费用等。结果两组新生儿窒息率无明显差异,两组产妇会阴Ⅱ度、Ⅲ度裂伤、产后尿储留及产后1~2 d会阴水肿疼痛发生率亦无明显差异;但研究组产后出血、产后抗生素使用率、产后平均住院时间及住院费用均显著少于对照组(P均<0.05)。结论会阴无保护改良产钳助产法简化了操作流程,但减少了妊娠期糖尿病母婴并发症,并有利于产后恢复,值得临床推广。

Objective To observe the effect of unprotected perineum improved forceps midwifery in pregnant women with gestational diabetes mellitus on the clinical outcomes of mothers and children. Methods 23 pregnant women with gestational diabetes mellitus treated with perineum unprotected and improved forceps midwifery to terminate pregnancy in Jiaxing Maternal and Child Health Hospital from October 1,2014 to September 30,2016 were chosen as study group. 23 cases of gestational diabetes mellitus using the traditional force clamp method at the same period were chosen as control group. The clinical data of the two groups were retrospectively analyzed.The neonatal asphyxia rate,maternal postpartum hemorrhage,perineum degree Ⅱ and Ⅲ laceration, postpartum antibiotic use,postpartum urine retention, post-partum 1-2 d perineal edema pain incidence,postprandial mean hospitalization time and hospitalization cost between the two groups were compared. Results There was no significant difference in the rates of asphyxia between the two groups. There was no significant difference in perineum degree Ⅱ and Ⅲ laceration,postpartum urine retention and postpartum 1-2 d perineal edema and pain incidence in the mothers between the two groups. But the postpartum hemorrhage, post- partum antibiotic use rate, postprandial mean hospitalization time and hospitalization cost in the study group were significantly less than those of the control group（all P〈0.05）. Conclusion The unprotected perineum improved forceps mid- wifery simplifies the operation process, but reduces the complications of gestational diabetes mellitus mothers and new-borns, which is conducive to postpartum recovery and worthy of clinical promotion.