跪趴体位在臀位接产中的应用研究

Application of Kneeling Position in Breech Delivery

目的:观察跪趴体位在臀位接产中的应用。方法:选取笔者所在医院2019年4月-2020年5月收治的单臀先露分娩产妇50例,采用随机数字表法分成对照组与研究组,各25例,对照组采取第一产程自由体位、第二产程传统体位的分娩方法,而研究组采取第一产程自由体位、第二产程跪趴体位的分娩方法。对比两组产妇产程时间、产后出血情况、新生儿与产妇情况。结果:两组第一产程、第三产程时间比较差异无统计学意义(P>0.05),研究组第二产程及总产程时间均短于对照组,差异均有统计学意义(P<0.05)。研究组产后出血量少于对照组,研究组产后出血率(8.00%)低于对照组(32.00%),差异均有统计学意义(P<0.05)。两组新生儿Apgar评分比较差异无统计学意义(P>0.05),研究组新生儿窒息率(4.00%)、后出头困难率(8.00%)、会阴裂伤率(12.00%)均低于对照组(24.00%、36.00%、48.00%),差异均有统计学意义(P<0.05)。结论:单臀先露分娩产妇的分娩体位选择中,采取第一产程自由体位第二产程跪趴体位的分娩体位方法,可明显缩短第二产程时间,进而缩短总产程时间,减少对产妇因为分娩所引发的痛苦,减少产后出血量与产后出血率,有效降低了新生儿窒息率、后出头困难率,更加有效保护产妇会阴,降低会阴裂伤率,效果理想。

Objective:To observe the application of kneeling position in breech delivery.Method:A total of 50 puerpera with single buttocks first exposed delivery admitted to our hospital from April 2019 to May 2020 were selected and divided into the control group and the research group by random number table method,with 25 cases in each group,the control group received the first free labor position and the second traditional labor position,while the study group received the first free labor position and the second kneeling and prostrate labor position.The duration of labor,postpartum hemorrhage,neonatal and maternal conditions were compared between the two groups.Result:There was no significant difference in the time of the first stage of labor and the third stage of labor between the two groups(P>0.05).The time of the second stage of labor and the total stage of labor in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).The amount of postpartum bleeding in the study group was less than that in the control group,and the rate of postpartum bleeding in the study group(8.00%)was lower than that in the control group(32.00%),the differences were statistically significant(P<0.05).There was no significant difference in Apgar score between the two groups(P>0.05).The rates of neonatal asphyxia(4.00%),post-occurrence difficulty(8.00%)and perineal laceration(12.00%)in the study group were lower than those in the control group(24.00%,36.00%,48.00%),the differences were statistically significant(P<0.05).Conclusion:In the selection of delivery position for parturients with one-armed delivery,adopting the free position in the first stage of labor and the kneeling position in the second stage of labor can significantly shorten the time of the second stage of labor,thereby shortening the time of the total stage of labor,reduce the pain caused by childbirth to the parturient,reduce the amount of postpartum hemorrhage and the rate of postpartum hemorrhage,effectively reduce the rate of neonatal asphyxia,the rate of difficulty in the postpartum,protect the perineum of the parturient more effectively,and reduce the rate of perineal laceration,the effect is ideal.