改变产妇体位纠正骨盆倾斜度对妊娠结局的影响

Treatment of vertebral artery type cervicalspondylosis with acupotomy combined with drawing and stretching traction and its effect on cervical curvature

目的:探讨改变产妇体位纠正骨盆倾斜度对阴道分娩率和质量的影响。方法:选取2015年3月至2017年5月在岑溪市人民医院妇产科分娩的160例产妇为研究对象,其骨盆倾斜度均≥70°,按照随机数字表法将其分为观察组和对照组,每组80例产妇。观察组产妇在分娩过程中进行坐式或半卧式体位指导,对照组产妇不给予特殊体位指导。比较两组产妇的分娩情况、产程时间和分娩后的新生儿情况。结果:在新生儿情况上,观察组的新生儿发生轻度窒息、重度窒息、颅内出血、头颅血肿,缺氧缺血性脑病的比重均低于对照组,其差异无统计学意义(P> 0. 05);在分娩方式上,观察组中有71. 3%的产妇经阴道分娩,明显高于对照组中38. 8%的产妇,两者差异具有统计学意义(χ~2=17. 071,P <0. 05);观察组产妇在胎吸助产、产钳助产、剖宫产上的比重明显低于对照组产妇,两者差异均有统计学意义(χ~2=4. 113、4. 737、14. 767,均P <0. 05);观察组产妇的会阴裂伤率(22. 5%)明显低于对照组产妇(63. 8%),两者差异具有统计学意义(χ~2=27. 75,P <0. 001);在产程时间上,观察组产妇的第一产程时间和第二产程时间均短于对照组产妇,两者差异均具有统计学意义(t=10. 491、41. 082,均P <0. 001)。结论:分娩过程中指导产妇通过改变体位的办法以纠正骨盆倾斜度,能够改善妊娠结局,提高阴道分娩率和缩短产程。

Objective:To investigate the effect of changing the position of the parturient to correct the rate of vaginal delivery and the quality of the vaginal delivery.Methods:160 pregnant women who gave birth at the Department of Obstetrics and Gynecology of People′s Hospital of Cenxi from March 2015 to May 2017 were selected as subjects,pelvic inclination are equal to or greater than 70 degrees.According to the random number table method,the observation group and the control group were divided into observation group and control group,80 cases in each group.The observation group was given sitting or semi horizontal posture guidance during delivery,while the control group did not give special posture guidance.Observation and comparison of two groups of parturients delivery,birth process time and newborns after childbirth.Results:In neonates,the proportion of neonates with mild asphyxia,severe asphyxia,intracranial hemorrhage,cranial hematoma and hypoxic ischemic encephalopathy was lower than that of the control group,but there was no significant difference between the two groups(P>0.05);In childbirth,the observation group of 71.3%maternal vaginal delivery,significantly higher than the control group 38.8%,the difference was statistically significant(χ^2=17.071,P<0.05);and the observation group in fetal suction forceps midwifery,cesarean section,the proportion is lower than the control group,the difference was statistically significant(χ^2=4.113、4.737、14.767,all P<0.05);The rate of perineal laceration was 22.5% in the observation group and 63.8%in the control group,and the difference was statistically significant(χ^2=27.75,P<0.001);On the labor time of the observation group,the duration of first stage and the second stage of labor was shorter than the control group,the difference was statistically significant(t=10.491,41.082,all P<0.001).Conclusions:In the course of childbirth,it guides the parturient to correct the pelvic inclination by changing the position of the body.It can improve the outcome of pregnancy, increase the rate of vaginal delivery and shorten the course of labor.