推广新产程标准对新生儿预后的影响

Influence of Promoting New Production Process Standard in Prognosis of Newborns

目的分析推广新产程标准前后新生儿预后相关指标,分析推广新标准的利弊,为分娩管理提供理论基础。方法 2015年5月—2016年5月,临床实践阶段,对深圳市福田区妇幼保健院选择阴道试产的孕产妇进行临床观察,经纳入、排除、退出,观察组与对照组分别完成研究500例,观察组按照新产程标准处理,对照组按旧产程标准处理,对比活跃晚期、第二产程时长、新生儿脐动脉血气分析、新生儿黄疸出现时间和黄疸指数指标,进行相关性分析。结果观察组与对照组的活跃晚期时间、新生儿脐动脉血p H、新生儿黄疸出现时间、黄疸指数峰值差异无统计学意义(P> 0. 05);观察组第二产程时间高于对照组,差异有统计意义(P <0. 05)。相关性分析显示,对照组的第二产程与新生儿脐动脉血p H存在相关性,差异有统计学意义(P <0. 05);观察组与对照组活跃期、第二产程与新生儿黄疸出现时间、黄疸指数峰值差无相关性;观察组第二产程与新生儿脐动脉血p H无相关性,差异无统计学意义(P> 0. 05)。结论新产程标准尽管延长了第二产程,但是不会影响新生儿脐动脉血p H,也不会加重新生儿黄疸。

Objective To analyze and promote the related indicators of prognosis of newborns before and after the new birth process, and to analyze the advantages and disadvantages of popularizing the new standard, so as to provide a theo- retical basis for childbirth management. Methods The pregnant and parturient women who selected the vaginal test in Shenzhen Futian District maternal and child health care hospital at the stage of clinical practice from May, 2015 to May, 2016 were observed in clinical, and 500 cases were studied in the observation group and the control group after inclusion, exclusion and withdrawal. The observation group was treated with standard treatment according to the new labor process, while the con- trol group was treated with the standard treatment for old production process. Then, the duration of active stage, second stage of labor, neonatal umbilical artery blood gas analysis, neonatal jaundice occurrence time and jaundice index were compared, and its correlation were analyzed. Results There was no significant difference in the active late time, the pH of the umbili cal artery blood of the newborn, the time of neonatal jaundice and the peak of jaundice index between the observation group and the control group （P 〉 0.05 ）. The second stage of labor time in the observation group was higher than the control group, the difference was statistically significant （P 〈 0. 05 ）. Correlation analysis showed that there was correlation in the second stage of labor and neonatal umbilical artery blood pH in the control group, and the difference was statistically significant （ P 〈 0.05 ）. There was no eorrelation between the active phase and the second stage of labor and the neonatal jaundice, jaundice index peak time in the observation group and control group, and there was no correlation in the second stage of labor and neo- natal umbilical artery blood pH in the observation group, and the difference was not statistically significant （ P 〉 0.05 ）. Con- clusion Although the new production process standard extend the second stage of labor,but it will not affeet umbilical artery- blood gas pH of newborn, nor will it aggravate neonatal jaundice.