Kielland产钳“改良牵引法”在持续性枕横位低位产钳助产术中的应用

Application of Kielland Forceps"Improved Traction Method"in Continuous Mid-Occipital Lateral Position Forceps

目的:研究Kielland产钳"改良牵引法"在持续性枕横位低位产钳助产术中的应用。方法:选取2017年6月~2017年12月沈阳市妇婴医院收治的符合纳入标准的经Kielland产钳助产的产妇300例作为临床研究对象,随机选取观察组产妇150例采用"改良牵引法"助产,对照组产妇150例采用"王历牵引法"助产。对两组产妇的母婴安全(并发症发生率)进行比较评价。结果:观察组产妇牵引均一次成功,对照组产妇有2例第一次牵引失败,重新放置产钳后成功。母亲并发症发生情况对比:观察组产妇发生阴道壁裂伤、宫颈裂伤、会阴Ⅲ度裂伤、产后出血例数分别为:20例,3例,2例,10例,对照组分别为:36例,4例,6例,20例;新生儿并发症发生例数对比:观察组发生轻度窒息2例,面部皮肤损伤6例,对照组发生轻度窒息3例、面部皮肤损伤15例。两组产妇的宫颈裂伤及新生儿轻度窒息发生例数比较无统计学差异(P>0.05),其余评价指标差异均具有统计学意义(P<0.05)。结论:Kielland产钳"改良牵引法"应用于持续性枕横位低位产钳助产术中,减少了产妇及新生儿的并发症发生率,保障了母婴安全。

Objective:To study the application of Kielland forceps"improved traction method"in the continuous mid-occipital lateral low forceps forceps.Methods:From June 2017 to December 2017,300 women who were admitted to the Shenyang Maternity and Infant Hospital by Kielland forceps were selected as clinical research objects.150 women in the observation group were randomly selected to use the"improved traction method"for delivery,and 150 women in the control group were used."Wangli traction method"midwifery.The maternal and infant safety(complication rate)of the two groups of women was compared and evaluated.Results:The traction of the pregnant women in the observation group was successful at one time,and 2 cases of the pregnant women in the control group failed in the first traction.Comparison of mother complications:the number of cases of vaginal wall laceration,cervical laceration,perineal third-degree laceration and postpartum hemorrhage in the observation group were:20 cases,3 cases,2 cases,10 cases,and the control group were:36 cases,4 cases,6 cases,20 cases;comparison of the number of neonatal complications:2 cases of mild asphyxia in the observation group,6 cases of facial skin damage,3 cases of mild asphyxia in the control group,and 15 cases of facial skin damage.There was no statistically significant difference in the number of cases of cervical laceration and neonatal mild asphyxia between the two groups(P>0.05),and the differences in the remaining evaluation indicators were statistically significant(P<0.05).Conclusion:The"improved traction method"of Kielland forceps is used in the continuous mid-occipital low-position forceps midwifery operation,which reduces the incidence of maternal and neonatal complications and ensures the safety of mothers and infants.