孕妇体位改变及子宫切口选择对第二产程剖宫产的影响

The influence of pregnant women′s posture changes and uterine incision selection on the second stage of cesarean section

目的探讨孕妇体位的改变及子宫切口的选择对第二产程剖宫产的影响。方法选择2017年1月—2020年1月于新余市妇幼保健院住院分娩已进入产程无法自然分娩需行剖宫产的100例孕妇作为研究对象,按照随机数字法分为研究组(50例)和对照组(50例)。研究组采用新型孕妇体位及子宫切口行剖宫产,对照组采用传统方法剖宫产。比较两组术中及术后2 h子宫出血、手术时间、胎儿娩出时间,新生儿及产妇不良反应发生情况。结果研究组术中、术后2 h的子宫出血量均少于对照组,差异有统计学意义(P<0.05)。研究组的手术时间与胎头娩出时间均短于对照组,差异有统计学意义(P<0.05)。研究组的新生儿及产妇不良反应总发生率均低于对照组,差异有统计学差异(P<0.05)。结论采用新的孕妇体位及子宫切口的选择可以减少第二产程剖宫产术中出血量,缩短手术时间及胎儿娩出时间,同时可以改善产妇总的不良反应率及新生儿不良反应率。

Objective To explore the influence of the change of pregnant women′s position and the choice of uterine incision on the second stage of cesarean section.Methods A total of 100 pregnant women hospitalized in Xinyu Maternity and Child Health Hospital who had entered the labor process and could not deliver naturally and who needed cesarean section were selected as the research subjects.According to the random number method,they were divided into study group(50 cases)and control group(50 cases).The study group was treated with cesarean section with new maternal position and uterine incision,while the control group was treated with cesarean section with traditional method.The intraoperative and 2 h postoperative uterine bleeding,the operation time,the time of fetal delivery,and the occurrence of adverse reactions of the neonates and the puerperae were compared between the two groups.Results The amount of uterine bleeding in the study group during and 2 h after operation was less than that of the control group,with statistical significance(P<0.05).The operation time and delivery time of the fetal head in the study group were shorter than those in the control group,with statistical significance(P<0.05).The total incidence of adverse reactions in neonates and puerperae in the study group was lower than that in the control group,with statistical significance(P<0.05).Conclusion Adopting the new posture of pregnant women and the choice of uterine incision can reduce the amount of bleeding during cesarean section in the second stage of labor,shorten the operation time and the time of fetal delivery,and meanwhile can improve the overall adverse reaction rate of puerperae and the adverse reaction rate of the neonates.