手膝俯卧位分娩与等待至少一次宫缩原则的效果分析
수슬부와위분면여등대지소일차궁축원칙적효과분석
Waiting for a contraction and on your hands and knees position delivery in the prevention of shoulder dystocia and baby injury
  • 万方数据
    中国生育健康杂志 중국생육건강잡지
    CHINESE JOURNAL OF REPRODUCTIVE HEALTH
    2014年 3期 219-222,229 ,共5页

    张宏玉%赵宁宁%卢玉静%刘炳芹%陈敏%郭保岩%李迎霞%管付娟%吴俊芹%刘喜荣%黄丽华%肖震萍%郭肖兰%马风兰%任利容%杨玉红%马竹云%张晓丽%张惠欣%周肖郁%刘健玲%郭仁妃%王爱宝%李静%马绮梨%何丽平

    장굉옥%조저저%로옥정%류병근%진민%곽보암%리영하%관부연%오준근%류희영%황려화%초진평%곽초란%마풍란%임리용%양옥홍%마죽운%장효려%장혜흔%주초욱%류건령%곽인비%왕애보%리정%마기리%하려평

    手膝俯卧位分娩%等待至少一次宫缩娩肩%肩难产%头-肩时间 手膝俯臥位分娩%等待至少一次宮縮娩肩%肩難產%頭-肩時間
    수슬부와위분면%등대지소일차궁축면견%견난산%두-견시간
    Hands and knees position delivery%Supine position delivery%Shoulder dystocia%Waiting for a contraction principle%Head to shoulder interval
    目的：分析比较手膝俯卧位分娩与平卧位分娩在采用等待娩肩的措施时对母婴结局的影响。方法共有621例产妇进入临床研究，其中手膝卧位组364例，平卧位组257例，两组均采用等待至少1次宫缩娩肩助产方式。比较两组的肩难产发生率、产程时间、产后出血、新生儿评分、头-肩时间等指标。结果产妇分娩的头-肩时间为5～480 s，平均（53.6±40.1）s；头-肩时间≤60 s 与＞60s 比较，新生儿窒息率差异无统计学差异，头-肩时间≤120 s 与＞120 s 比较，新生儿窒息率增高，差异有统计学意义。手膝俯卧位组与平卧位组的头-肩时间分别为（60.1±46.8）s 和（44.5±25.6）s，差异有统计学意义。手膝俯卧位与平卧位的肩难产发生率分别为0，1.6％，差异有统计学意义。新生儿窒息的发生率分别为1.4％，1.9％，两组差异无统计学意义。结论采用手膝俯卧位分娩和等待至少一次宫缩自然娩肩，减少肩难产发生率，不增加新生儿窒息率，是安全可行的助产方法。
    목적：분석비교수슬부와위분면여평와위분면재채용등대면견적조시시대모영결국적영향。방법공유621례산부진입림상연구，기중수슬와위조364례，평와위조257례，량조균채용등대지소1차궁축면견조산방식。비교량조적견난산발생솔、산정시간、산후출혈、신생인평분、두-견시간등지표。결과산부분면적두-견시간위5～480 s，평균（53.6±40.1）s；두-견시간≤60 s 여＞60s 비교，신생인질식솔차이무통계학차이，두-견시간≤120 s 여＞120 s 비교，신생인질식솔증고，차이유통계학의의。수슬부와위조여평와위조적두-견시간분별위（60.1±46.8）s 화（44.5±25.6）s，차이유통계학의의。수슬부와위여평와위적견난산발생솔분별위0，1.6％，차이유통계학의의。신생인질식적발생솔분별위1.4％，1.9％，량조차이무통계학의의。결론채용수슬부와위분면화등대지소일차궁축자연면견，감소견난산발생솔，불증가신생인질식솔，시안전가행적조산방법。
    Objective To examine the adaptation of waiting for a contraction principle and on your hands and knees positions delivery on maternal and neonatal outcomes. Methods A total of 621 of women with vaginal delivery were enrolled.Women willing to delivery on your hands and knees position were assigned to the experimental group (364cases),and the controlled group included women on supine position delivery (257 cases).Both groups were adapted to waiting for one contraction after head delivered.The rate of shoulder dystocia,labor process,postpartum hemorrhage, Apgar score and time of head to shoulder interval were recorded. Results The head to shoulder interval was from 5 s to 480 s,with an average of (53.6 ±40.1)s.The rate of asphyxia between the head to shoulder intervals of (60 s and >60 s was not statistically different,but the rate was higher in those of head to shoulder interval >120s as compared with interval (120s.The head to shoulder interval was longer in hands and knees position (60.1 ±46.8)s than in supine position (44.5 ±25.6)s.The rate of shoulder dystocia in hands and knees position was lower than that in supine position delivery (1.6%,4 /257).The rates of asphyxia in hands and knees position (1.4%,5 /364)and in supine position (1.9%, 5 /257)were not statistically different. Conclusion Hands and knees position delivery and awaiting for a contraction method had lower rate of shoulder dystocia,with no increase in asphyxia.
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