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目的:探讨徒手转胎位处理头位难产的手术时机和临床效果。方法:选取十堰市郧县妇幼保健院妇产科2009年1月～2011年1月收治的186例头位难产产妇,随机平均分为两组,观察组采用徒手转胎位处理,对照组采用胎头吸引术,比较两组临床效果、产程及产后出血情况。结果:观察组经徒手转胎位处理头位难产后经阴道分娩成功率为95.7%,对照组分娩成功率于为74.1%,观察组明显高于对照组(P<0.05),对两组未能成功分娩者采用剖宫产术或产钳助产术,母婴均平安,两组患者产程及产后出血比较差异有统计学意义(P<0.05)。两组新生儿NBNA总分均>35分,其中观察组新生儿总分为(38.11±1.13)分,对照组新生儿总分为(38.11±1.13)分。两组新生儿的各项NBNA评分指标比较,差异均无统计学意义(P>0.05)。结论:徒手转胎位是处理头位难产的重要手术,在掌握适应证的前提下,使难产变为顺产,可有效降低阴道助产及剖宫产率,减少母婴并发症。
Objective: To investigate the timing and clinical effect of hand-free delivery of fetal head in the treatment of dystocia. Methods: Totally 186 pregnant women with first position who were admitted to Obstetrics and Gynecology Department of Yunxian Maternal and Child Health Hospital of Shiyan City from January 2009 to January 2011 were randomly divided into two groups. The observation group was treated with unilateral hand shift and the control group with fetal Head suction surgery, the clinical effect of two groups, labor and postpartum hemorrhage. Results: The success rate of transvaginal delivery in the head position treated by hand in the observation group after dystocia was 95.7%, the success rate in the control group was 74.1%, the observation group was significantly higher than the control group (P <0.05) Successful delivery by cesarean section or forceps midwifery, mother and child were safe, the two groups of patients with labor and postpartum hemorrhage difference was statistically significant (P <0.05). The score of neonatal NBNA in both groups was> 35, with the score of newborn in the observation group being (38.11 ± 1.13) points and that of the control group (38.11 ± 1.13) points. Neonates of the two groups of NBNA score indicators, the difference was not statistically significant (P> 0.05). CONCLUSION: Free hand rotation of the fetal position is an important operation for the treatment of head dystocia. Under the premise of mastering indications, dystocia can be changed to natural delivery, which can effectively reduce the incidence of vaginal delivery and cesarean section and reduce the complications of both mother and infant.