新第二产程时限对母婴预后及剖宫产率的影响的研究.docVIP

新第二产程时限对母婴预后及剖宫产率的影响的研究 　　[摘要] 目的 通过对比新、旧第二产程下产后出血及新生儿窒息发生率的差异性及剖宫?a率变化，分析新第二产程标准是否对母婴安全且能有效降低剖宫产率。 方法 回顾性分析2013年1月～2016年8月在我院分娩的产妇，选择单胎、头位，排除产科并发症、合并症，共计8163例。根据新旧第二产程时间标准不同，分成两组，第一组为执行旧第二产程标准的产妇，定义为对照组。第二组为执行新第二产程标准的产妇，定义为观察组。分别统计产后出血率、新生儿窒息率以及我院剖宫产率变化等观察指标，通过数据分析统计各组之间有无统计学差异。 结果 对照组和观察组在产后出血率、新生儿窒息率方面均无统计学差异（P0.05），观察组在剖宫产率方面比对照组有降低，有统计学差异（P0.05）。 结论 新第二产程未导致产后出血率及新生儿窒息率升高，未增加母婴风险，且能有效降低剖宫产率，促进阴道分娩，值得推广。 　　[关键词] 新第二产程时限；旧第二产程时限；母婴安全；剖宫产率；产后出血；新生儿窒息 　　[中图分类号] R714 [文献标识码] A [文章编号] 2095-0616（2017）08-100-03 　　[Abstract] Objective Manage two groups with different labor time limit. The rate of postpartum hemorrhage， neonatal asphyxia and cesarean section were compared between the two groups. And then analyze whether the new labor time limit is safe for mothers and babies and can effectively reduce the rate of cesarean section. Methods Data were retrospectively analyzed from 8163 maternals delivering a singleton infant in cephalic position excluding obstetric complications in our hospital from January 2013 to August 2016. They were divided into control group （4512 cases） and observation group （ 3651 cases） . Postpartum hemorrhage rate， neonatal asphyxia rate and cesarean section rate were observed. Results There was no significant difference between the control group and the observation group in the rate of postpartum hemorrhage and neonatal asphyxia （P0.05）， while the rate of cesarean section in the observation group was lower than that in the control group （P0.05）. Conclusion The new second stage of labor duration showed no obvious increase rate of postpartum hemorrhage and neonatal asphyxia，did not increase the risk of maternals and infants， and can effectively reduce the rate of cesarean section， promote vaginal delivery， worthy of promotion. 　　[Key words] The new second stage of labor duration； The old second stage of labor duration； Maternals and babies safety； Cesarean section； Postpartum hemorrhage； Neonatal asphyxia 　　为降低剖宫产率，促进阴道分娩，2014年7月《中华妇产科杂志》推荐“