第二产程中使用一次性胎头真空吸引器的效果及人文关怀和体位活动的影响

The clinical effects of disposable fetal head vacuum extractor in the second stage of labor and the its influencing factors

目的分析第二产程中使用一次性胎头真空吸引器的临床效果,以及人文关怀对其使用影响的研究。方法回顾性选取2019年10月至2020年8月需要阴道助产的产妇60例,依据助产方法分为一次性胎头真空吸引器组(真空吸引器)和产钳助产组,每组30例。分析2组产妇的助产操作时间、第二产程时间、总产程时间、术中、术后出血量、产妇损伤情况、新生儿Apgar评分、新生儿损伤情况、产妇中转剖宫产情况。结果真空吸引器组产妇的第二产程时间显著短于产钳助产组(P<0.05),术中、术后出血量均显著少于产钳助产组(P<0.05),但2组产妇的助产操作时间、总产程时间差异均无统计学意义(P>0.05)。真空吸引器组产妇会阴侧切、会阴水肿、阴道壁损伤、尿潴留、产后出血发生率分别为10.00%(3/30)、3.33%(1/30)、10%(3/30)、0(0/30)、0(0/30),均显著低于产钳助产组的33.33%(10/30)、26.67%(8/30)、33.33%(10/30)、20.00%(6/30)、20.00%(6/30)(P<0.05)。真空吸引器组和产钳助产组新生儿出生后1 min、5 min、10 min Apgar评分差异均无统计学意义(P>0.05)。真空吸引器组新生儿面部损伤发生率为0(0/30)显著低于产钳助产组的13.3%(4/30)(P<0.05),头皮下血肿发生率23.33%(7/30)显著高于产钳助产组0(0/30)(P<0.05)。真空吸引器组产妇中转剖宫产率差异无统计学意义(P>0.05)。结论第二产程中使用一次性胎头真空吸引器的临床效果较产钳助产好,对于无分娩信心的产妇给予人文关怀可降低助产率。

Objective To investigate the clinical effects of disposable fetal head vacuum extractor in the second stage of labor and the effects of humanistic care nursing on its appliaction.Methods A total of 60 parturients who needed vaginal delivery in our hospital from October 2019 to August 2020 were enrolled in the study,who were divided into two groups according to the methods of delivery:one-time fetal head vacuum suction group(vacuum suction group)and forceps delivery group,with 30 cases in each group.The operation time,the second stage of labor,the total stage of labor,intraoperative and postoperative bleeding,maternal injury,Apgar score,neonatal injury and transfer cesarean section status were observed and compared between the two groups.Results The time of second stage of labor and the intraoperative and postoperative hemorrhage volume in vacuum suction group were significantly less than those in forceps delivery group(P<0.05).However there were no significant differences in operation time and total duration of labor between the two groups(P<0.05).The incidence rates of perineal lateral incision,perineal edema,vaginal wall injury,urinary retention and postpartum hemorrhage volume in vacuum suction group were significantly lower than those in forceps delivery group(P<0.05).There were no significant differences in Apgar scores at 1min,5min and 10min after neomnate birth between the two groups(P>0.05).The incidence of facial injury in vacuum aspirator group was significantly lower than that in forceps group(0 vs 13.3%,P<0.05),and the incidence of subscalp hematoma(23.33%)was significantly higher than that(0)inforceps group(P<0.05).There was no significant difference in transfer cesarean section rate between the two groups(P>0.05).Conclusion The clinical effects of using one-time fetal head vacuum aspirator in the second stage of labor is better than those by forceps delivery.