胎吸术和产钳术在头位难产中应用的比较分析

胎头吸引术(简称胎吸术)和产钳术是头位阴道分娩中两种常用的助产方法。正确掌握二者的适应证及其操作方法,是降低围产儿患病率、死亡率和产妇并发症,提高产科医疗质量的一个重要内容。本文对我院1981年1月至1990年12月3846例次手术产资料进行分析,结果报道如下。1 临床资料1.1 手术率:10年内分娩总数35815人次。

剖宫产出血防治的探讨

1983年1月～1992年12月我科共行剖宫产4731例，出血量≥500ml者374例，出血率7.90％，是同期阴道分娩出血率2.25％（193/8577）的3.5倍。引起剖宫产出血的主要原因有：子宫收缩乏力（235例，62.83％）、前置胎盘（69例，18.45％）、子宫切口撕裂（35例，9.36％）。在374例中，7例因出血无法控制行子宫切除术（1.87％），本组无产妇死亡。结合本组资料，对剖宫产出血的主要原因及其防治进行了讨论。

产力宝对人离体妊娠子宫平滑肌条收缩性的影响

利用离体肌肉张力实验观察中药方剂产力宝对人离体妊娠子宫平滑肌条收缩性的影响 ,结果显示 :产力宝能明显提高子宫平滑肌的收缩幅度及收缩频率 (P<0 .0 1) ,从而增强其收缩力。但其影响力不及缩宫素 (P<0 .0 5 )。不同浓度的产力宝对子宫平滑肌收缩性的影响程度差异无显著性 (P>0 .0 5 )。这可能就是产力宝加速产程的机理之一。

产力宝加速第二产程的研究

目的 :观察中药产力宝在第二产程中的临床效果。方法 :将观察期间本院经阴道分娩的初产妇随机分为 3组 ,分别为产力宝组(80例 )、催产素组 (5 2例 )及自然分娩组 (2 9例 ,不用任何药物) ,观察比较各组第二产程时间及母儿预后 ,并通过电子监护仪进行内监护测定子宫内压及胎儿心率变化。结果 :产力宝组产妇第二产程时间及产后出血量均明显小于自然分娩组 ,其平均子宫内压明显高于后者 ,但与催产素组间无显著性差异。对新生儿预后无不良影响。结论 :产力宝具有显著加强产力 ,缩短第二产程作用 ,副作用小 ,给药方便 ,不失为临床一安全有效的改善母儿预后的药物 ,尤其适用于不宜使用催产素及不宜大量输液者。

Clinical Effects and Mechanism of Chanlibao in Accelerating Second Stage of Labor

To observe the clinical effects and the mechanism of Chanlibao (CLB, a preparation of Chinese herbal medicine) in accelerating second stage of labor, primiparae were divided into 3 groups at random. CLB or oxytocin (OTC) was given to the CLB group ( n =80) and the OTC group ( n =52) respectively. The third group served as controls ( n =29). The control group consisted of women experiencing natural labor and to whom no drug was given. The time of second stage of labor and prognosis of mother and newborn of different groups were observed and compared. And intrauterine pressure and fetal heart rate were monitored by means of electronic monitoring. Isolated uterine muscular tissue was used to observe the reactivity to CLB. The results showed that the time of second stage of labor and postpartum hemorrhage in the CLB group were less than those in the control group and the average intrauterine pressure in the former was higher than that in latter, so was the contraction strength of isolated uterine muscle, but with no difference as compared with the OTC group. No side effect of CLB was found. It is concluded that CLB could obviously strengthen uterine contraction and accelerate second stage of labor. Moreover, it is inexpensive, convenient and free of side effect. It can be used as a new, safe and effective alternative for improving prognosis of mother and newborn, especially those not indicated for oxytocin or profuse infusion.