摘要
目的探讨胎头深陷骨盆转剖宫产术患者体位及上推胎头时机对取胎成功率与手术并发症的影响。方法抽取2019年1月至2021年12月焦作市妇幼保健院收治的胎头深陷骨盆转剖宫产术患者86例,根据双色球法分为对照组和观察组,每组43例。对照组患者采用平卧位,于上推胎头前将子宫切开或上推胎头后将子宫切开;观察组患者采用头低脚高位,于上推胎头后将子宫切开。比较两组手术时间、胎儿娩出时间、出血量及住院时间,比较两组取胎头成功率,1、5 min新生儿Apgar评分,比较两组手术并发症发生情况。结果观察组手术时间、胎儿娩出时间、出血量、住院时间均少于对照组(P均<0.05);观察组取胎头成功率高于对照组,但差异未见统计学意义(P>0.05);观察组1、5 min新生儿Apgar评分高于对照组(P<0.05);观察组并发症总发生率(13.95%,6/43)低于对照组(37.21%,16/43),差异有统计学意义(P<0.05)。结论与平卧位、上推胎头前将子宫切开或上推胎头后将子宫切开相比,胎头深陷骨盆转剖宫产术患者采取头低脚高位、上推胎头后将子宫切开处理,可缩短手术时间、胎儿娩出时间及住院时间,同时可减少手术出血,改善新生儿Apgar评分,减少术后并发症发生。
Objective To investigate the influence of body position and timing of pushing fetal head upward on the success rate of fetal head extraction and surgical complications in patients converted to cesarean section for fetal head deeply engaged in the maternal pelvis.Methods A total of 86 patients converted to cesarean section for fetal head deeply engaged in the maternal pelvis in Jiaozuo Maternal and Child Health Hospital from January 2019 to December 2021 were selected,and they were divided into control group and observation group according to the two-sphere method,with 43 cases in each group.The patients in the control group took a flat lying position and cut the uterus before or after pushing the fetal head up;the patients in the observation group were in a low head and high foot position,and the uterus was cut after pushing the fetal head up.The operation time,fetal delivery time,bleeding volume and hospital stay of the two groups were compared,the success rate of fetal head extraction,1-minute and 5-minute neonate Apgar score in the two groups were compared.The complications of the two groups were compared.Results The operation time,fetal delivery time,blood loss and hospital stay in the observation group were lower than those in the control group(all P<0.05).The success rate of fetal head extraction in the observation group was higher than that in the control group,but there was no significant difference between the two groups(P>0.05).The 1-minute and 5-minute neonate Apgar scores of newborns in the observation group at 1 min and 5 min were higher than those in the control group(P<0.05).The total incidence of complications in the observation group(13.95%,6/43)was lower than that in the control group(37.21%,16/43),P<0.05.Conclusions Compared with the flat position and cutting the uterus before or after pushing the fetal head upward,for patients converted to cesarean section because of fetal head deeply engaged in the maternal pelvis the method of cutting the uterus after pushing the fetal head upward with the position of head low and foot high can shorten the operation time,fetal delivery time,hospital stay,reduce the operation bleeding,improve the Apgar score of the newborn,reduce the postoperative complications.
作者
刘丽霞
Liu Lixia(Department of Obstetrics,Jiaozuo Maternal and Child Health Hospital,Jiaozuo 454000,China)
出处
《中国实用医刊》
2023年第4期32-35,共4页
Chinese Journal of Practical Medicine
关键词
剖宫产
胎头深陷骨盆
体位
上推胎头时机
取胎头成功率
手术并发症
Cesarean section
Fetal head deeply engaged in the maternal pelvis
Body position
Timing of pushing the fetal head upward
Success rate of fetal head extraction
Surgical complications
