新产程解读说课材料.pptxVIP

新产程解读—2014新产程标准及处理的专家共识;“; 1955 1959~1965 2008~2008 n＝500 n＝26 838 n＝228 668 P0 P0 P1 P2 P0 P1 P2 年龄 20~30（70％） 20 23 27 25 28 30 CDR（％）1.8 5.6 30.5 引产（％） 4.4 7.1 36.2 催产（％） 9.1 12~20 45~47 产钳（％） 55.5 73 17 ;我国产科现状：高剖宫产率（CDR）;全球及我国剖宫产现状;我国分娩数据的变化（40年跨度）;传统产程图的问题;产程图应用中遇到的问题;;Conclusion: On the basis of the findings of this review, we cannot recommend routine use of the partogram as part of standard labour management and care. Given the fact that the partogram is currently in widespread use and generally accepted, it appears reasonable, until stronger evidence is available, that partogram use should be locally determined. Further trial evidence is required to establish the efficacy of partogram use. FROM：Effect of partogram use on outcomes for women in spontaneous labour at term. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD005461. 2009年WHO不在推荐在产程管理中常规使用产程图。;我国产程研究;新产程在中国的推广;;新产程标准及处理;新产程标准及处理;新产程标准及处理;新产程在我国的落地、推广、挑战;核心文献复习-1;研究对象的筛选;产程曲线;平均分娩时间;第95%分位分娩阶梯图;结论;核心文献复习-2;RESULTS: The median time needed to progress from one centimeter to the next became shorter as labor advanced (eg, from 1.2 hours at 3–4 cm to 0.4 hours at 7–8 cm in nulliparas). Nulliparous women had the longest and most gradual labor curve; multiparous women of different parities had very similar curves. Nulliparas may start the active phase after 5 cm of cervical dilation and may not necessarily have a clear active phase characterized by precipitous dilation. The deceleration phase in the late active phase of labor may be an artifact in many cases. 结果：当产程进展时，宫口扩张1cm的所需时间逐渐缩短(eg, from 1.2 hours at 3–4 cm to 0.4 hours at 7–8 cm 初??妇)，初产妇有最长和最慢的产程曲线，不同