探讨适宜体位在分娩时第二产程中的临床意义.docVIP

适宜体位在分娩中的临床意义 摘要：本文旨在探讨适宜体位在分娩时第二产程中矫正枕后位的临床意义及可行性。方法选择2009年8月至2010年8月在医院分娩的初产妇356例，随机分为观察组178例和对照组178例。两组产妇I临产后在一般护理的基础上，观察组进行体位矫正，对照组不作体位矫正。结果观察组第一和第二产程时间均低于对照组(P0．01)，顺产率明显高于对照组(P0．01)，剖宫产率明显低于对照组(P0．01)，胎儿宫内窘迫发生率明显低于对照组(P0．05)，经阴道分娩产后出血量明显低于对照组(P0．05)。经研究发现枕后位产妇通过改变体位矫正枕后位，不但能降低难产的发生率及剖宫产率，且有助于提高分娩质量和减少产儿受伤的风险。关键词：自由体位 常规体位 Abstract：This papers aims to investigate the clinical significance and feasibility of correction of posterior position by making use of appropriate position in the second stage of labor during childbirth. Methods are to choose mainly 356 cases of primipara who were giving birth in a hospital from August 2009 to August 2010, and the cases were randomly divided into two groups, in which, 178 cases were diagnosed as observed group and others as control group. Two groups of maternal were on the basis of care in general after labor, the observed group gone in postural correction, the control group without postural correction. The results are, observed group in the first and second stage of labor time were lower than the control group (P 0.01), higher significantly in the shun yield (P 0.01),lower in the Cesarean section rate (P0.01), the incidence of fetal distress(P0.05), also lower in the Postpartum hemorrhage after vaginal delivery(P0.05). Conclusively, the maternal who are posterior position correct posterior position by changing posture, not only can reduce the incidence of dystocia and cesarean section rate, and also help to improve the delivery quality and reduce the risk of injury births. Key words: Occiput posterior position; Freestyle position; Prescriptive position; Standard position 枕后位是头先露中一种常见的胎方位，是头位难产的主要原因，已跃居剖宫产指征的第2位[1]，因此矫正枕后位对于降低剖宫产率具有重要意义。我科对178例待产妇实施产程中特殊体位指导，促使枕后位逐渐转至枕前位自然分娩，取得了满意的效果，现总结如下1、资料与方法 11 一般资料 从我科2008年1月至2009年1月观察356例，年龄22～32岁，孕周为36-42周，单胎头位，骨盆外测量及内测量为正常女性骨盆，有产兆入院的产妇。无严重妊娠并发症及妊娠合并症者3]。 1.2 诊断标准4]及体位 1.2.1 确定胎方位根据超声波判断抬头方位和脊方位。并参照凌萝达瓮关于胎方位的临床划分标准和内诊情况，确定胎头枕方位。 1.2.2 孕妇的体位胎方位正常，取自由体位。胎方位异常(如枕后位)，临产开始至宫口开全，行同侧侧腹