双叶产钳在二次剖宫产术中的临床应用分析

Clinicalapplication of double-leaf forceps in secondary cesarean section

目的探讨双叶产钳在疤痕子宫患者二次剖宫产术中的应用价值。方法采集解放军63650部队医院妇产科2015年8月将产钳应用于疤痕子宫二次剖宫产术胎头高浮者前后各1年的病例,分别作为对照组与观察组,进行回顾性队列研究,比较两组病例手术时间、术中出血量、新生儿出生体重、胎头娩出时间、子宫切口延裂及新生儿窒息情况。结果与对照组相比,观察组的胎头娩出时间明显缩短,差异有统计学意义(t=-2.85,P<0.05);新生儿窒息及子宫切口延裂发生率明显降低,差异均有统计学意义(χ~2值分别为8.16、7.67,均P<0.05),而新生儿出生体重、手术时间及术中出血量比较差异均无统计学意义(均P>0.05)。结论疤痕子宫患者再次剖宫产术中出现胎头高浮时应用双叶产钳具有快速、安全、有效地助娩胎头的优点。

Objective To investigate the clinical effect of double-leaf forceps on secondary cesarean section of scar uterus.Methods The patients 1 year before and after the use of double-leaf forceps on secondary cesarean section of scar uterus with high position fetal head in August 2015 were selected in the department of obstetrics and gynecology from 63650 Hospital of PLA as control group and observation group for retrospective cohort study to compare the operation time,intraoperative bleeding volume,birth weight,fetal head delivery time,uterine rupture rate and neonatal asphyxia.Results Compared with the control group,the fetal head delivery time of the observation group was significantly reduced(t=-2.85,P<0.05),and the incidence rates of neonatal asphyxia and uterine rupture were decreased significantly(χ~2 value was 8.16 and 7.67,respectively,both P<0.05).Birth weight,operation time and intraoperative bleeding volume were not significantly different(all P>0.05).Conclusion The application of double-leaf forceps in secondary cesarean section of scar uterus with high position fetal head has the advantages of being rapid,safe and effective for fetal head delivery.