分娩镇痛下徒手转胎位对妊娠期糖尿病合并难产患者的效果分析

Effect of Free Hand Fetal Position Transfer under Labor Analgesia on Patients with Gestational Diabetes Mellitus Complicated with Dystocia

目的:分析妊娠期糖尿病合并难产在分娩镇痛状态下采用徒手转胎位,对于其剖宫产率及会阴侧切率的影响。方法:针对泉州市妇幼保健院儿童医院2020年1-12月接收分娩的124例妊娠期糖尿病合并难产的临床资料进行回顾性分析。按照不同的处理方式分为产钳助产组(产钳助产术)45例与徒手转胎位组(分娩镇痛下徒手转胎位)79例。对比两组阴道分娩率、剖宫产率、会阴侧切率、会阴裂伤及裂伤程度、会阴疼痛程度、新生儿情况及并发症发生情况。结果:与产钳助产组相比,徒手转胎位组阴道分娩率较高,剖宫产率、会阴疼痛程度及并发症发生率均较低(P<0.05)。与产钳助产组阴道分娩者相比,徒手转胎位组阴道分娩者会阴侧切率、会阴裂伤率均较低(P<0.05),但两组会阴裂伤者在会阴裂伤程度上对比,差异无统计学意义(P>0.05)。结论:通过在分娩镇痛的基础上对妊娠期糖尿病合并难产采用徒手转胎位,剖宫产率、会阴侧切率大幅度下降,有效缓解会阴疼痛。

Objective:To analyze the effect of free hand fetal position transfer on cesarean section rate and perineal lateral resection rate of gestational diabetes mellitus complicated with dystocia during labor analgesia.Method:A retrospective analysis was made on the clinical data of 124 cases with gestational diabetes mellitus complicated with dystocia who received delivery in Quanzhou Women's and Children's Hospital from January to December 2020.According to different treatment methods,45 cases were divided into forceps assisted delivery group(forceps assisted delivery)and 79 cases were divided into free hand transfer group(free hand fetal position transfer under labor analgesia).The vaginal delivery rate,cesarean section rate,lateral perineal resection rate,perineal laceration and laceration degree,perineal pain degree,neonatal conditions and complications were compared between the two groups.Result:Compared with the forceps assisted delivery group,the vaginal delivery rate,cesarean section rate,perineal pain degree and complication rate were higher than those in the free hand transfer group(P<0.05).Compared with the vaginal delivery patients in forceps assisted delivery group,the lateral perineal incision rate and perineal laceration rate of vaginal delivery patients in the free hand transfer group were lower(P<0.05),but there was no statistical significance in the perineal laceration degree of patients with perineal laceration in the two groups was compared(P>0.05).Conclusion:On the basis of labor analgesia for gestational diabetes complicated with dystocia using free hand transfer of fetal position,the rate of cesarean section and perineal lateral resection decreased significantly,effectively relieve perineal pain.