针灸至阴穴矫正胎位不正临床观察及相关影响因素探析.docVIP

针灸至阴穴矫正胎位不正临床观察及相关影响因素探析 　【摘要】 目的 对比针灸至阴穴与膝胸卧位法矫正胎位不正的疗效，采用B超检查进行适时疗效观察。方法 观察组30例胎位不正的孕妇给予针灸至阴穴治疗，并与对照组30例胎位不正的孕妇行膝胸卧位治疗效果对比。结果 观察组有效率93.3%，对照组有效率53.3%，两组比较差异有非常显著性（Plt;0.01）。针灸至阴穴矫正胎位不正有效率明显高于单纯膝胸卧位法。结论 疗效与孕周大小、羊水多少、胎儿双顶径大小及胎盘附着在子宫的位置密切相关。 【关键词】 胎位不正；针刺疗法；穴位；至阴；超声检查；羊水；双顶径 Ultrasonic observation on relation of the therapeutic effect of acupuncture and moxibustion for correction of fetal position and clinical observation 【Abstract】 Objective To compare therapeutic effects of acupuncture and moxibustion at zhiyin(BL 67)and knee-chest position for correction of breech pregnancy.At the same time，the therapeutic effects was observed under ultrasonic monitoring.Methods The observation group(30 cases of breech pregnancy) were treated acupuncture and moxibustion at zhiyin(BL 67)，and the control group (30 cases) were treated with knee-chest position therapy. Results The effective rate was 93.3% in the observation group and 53.3% in the control group with a significant difference between the two groups（Plt;0.01）.The effective rate in the acupuncture and moxibustion at zhiyin(BL 67) theraphy for correction of breech pregnancy is obviously higher than that of the knee-chest position therapy.Conclusion At the same time，results found that the therapeutic effects were related with duration of pregnancy，amount of amniotic fluid，fetal biparietal diameter，as well as the placenta-adhered position on the utlerus. 【Key words】 abnormal fetal position;acupuncture;moxa-sick moxibustion;ultrasonography;amnioic fluidl;biparielal diameter 胎位是指胎儿在子宫腔中的位置。胎位不正是指妊娠28周后，胎儿在子宫腔内先露部分不是头部。中医学将胎位不正称为“倒产”、“横产”、“偏产”等，认为主要由于气血虚弱或气滞血瘀所致。西医学认为胎位不正与孕妇骨盆狭窄，子宫畸形，多产，腹壁过紧或过松，羊水过多或过少，软产道伸展不良，肿瘤，前置胎盘，胎儿过大或异常有关。 臀位是产科最常见的异常胎位之一，且容易发生脐带脱垂和分娩困难，围产儿死亡率、产伤所致各种损伤比头位分娩高数倍。由于剖宫产率的增高，使臀位分娩的围产儿死亡率有所降低。然而解决此问题的关键不在于无限制地提高剖宫产率。只有及时矫正胎位，才能减少高危臀位的临产率，才是降低围产儿死亡率及剖宫产率的有效措施。 1 资料与方法 1.1 一般资料 60例胎位不正孕妇均经我院产科门诊产检及超声检查确诊，无心、肝、肾病史、糖尿病等疾病及病理妊娠情况。超声孕龄评估与停经史计算的孕周相符。并除外多胎、胎儿畸形、子宫畸形、盆腔狭窄、头盆不称等不利于矫正胎位的因素。按就诊时间随机分为针灸组（观察组），单纯膝胸卧位组（