目前产科分娩量大,而且几乎都是初产妇,因此手术产的发生率上升。剖宫产术虽能解决不少难产,但产钳术仍有广阔的使用前途。在枕横位或枕后位时,Kjelland 氏产钳(简称吉兰产钳)有其独特的优点。本文通过我们的临床实践,介绍一下吉兰氏产钳的迂回上钳法.并通过临床资料阐述此方法的优点。资料和方法一、产钳操作的步骤吉兰氏产钳有三种上钳的方法:①古典上钳法:这种方法由于有在宫腔内转钳的步骤,蕴藏着很大的危险,早已不用。②迂回上钳法:即上前叶产钳是从胎儿面额部滑向颞部。③直插上钳法:使用机会不多。现以右枕横位为例介绍迂回上钳法:(一)准备:孕妇取膀胱截石位,两大腿尽量外旋。臀部要突出于床边2～3 cm,排空膀胱,阴道检查以确定胎头位置。作阴部神经阻滞麻醉,然后作会阴切开。术者先将涂过润滑油的合好的整把产钳 The current obstetric delivery volume, and almost all primipara, so the incidence of surgical production increased. Although cesarean section can solve a lot of difficult births, but still have a broad use of forceps ptosis. Kjelland forceps (referred to as Guillain forceps) have their unique advantages in the transverse or posterior occipital position. This article, through our clinical practice, introduces the circuitous top-clamp method of the Gillian forceps and elaborates the advantages of this method through clinical data. Materials and methods First, the steps of forceps operation Gill’s forceps There are three methods of forceps: ① Classical clamp method: Because of this method in the uterine cavity pliers steps, contains a lot of danger, long gone. ② detour on the clamp method: that is, from the fetus frontal forceps nip slide to the temporal portion. ③ straight on the clamp method: the use of few opportunities. Now take the right pillow transverse as an example to introduce the detour on the clamp method: (a) preparation: pregnant women take the bladder lithotomy position, two thighs try to external rotation. Hips should be prominent at the bed 2 ~ 3 cm, emptying the bladder, vaginal examination to determine the fetal head position. Perineal nerve block anesthesia, and then for the perineal incision. The surgeon first coated with a good lubricant of the whole forceps