發(fā)布時(shí)間：2018-04-19 18:56

  本文選題：人工破膜 + 自然破膜　； 參考：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年22期

【摘要】：目的對(duì)比分析人工破膜與自然破膜結(jié)合自由體位待產(chǎn)產(chǎn)婦的母嬰結(jié)局,探求更為安全有效的產(chǎn)程管理模式。方法以西藏民族大學(xué)附屬醫(yī)院產(chǎn)科2014年6月-2015年7月收治的170例產(chǎn)婦為研究對(duì)象,根據(jù)破膜方法分為人工破膜組(85例)與自然破膜組(85例),人工破膜組采用活躍期人工破膜并結(jié)合自由體位待產(chǎn),自然破膜組在自由體位待產(chǎn)模式下自然破膜待產(chǎn),對(duì)比兩組產(chǎn)婦分娩結(jié)局與新生兒結(jié)局的差異。結(jié)果人工破膜組因枕位異常、宮內(nèi)胎兒窘迫行剖宮產(chǎn)比例(22.4%)高于自然破膜組(9.6%)。人工破膜組經(jīng)陰道分娩產(chǎn)婦第1產(chǎn)程時(shí)間為(537.8±50.3)min,第2產(chǎn)程時(shí)間為(35.8±9.1)min,產(chǎn)后2 h出血量(182.4±37.5)ml,均略少于自然破膜組(549.5±57.3)min、(38.5±10.5)min和(190.7±40.4)ml;宮頸撕裂(4.5%)、宮頸水腫(4.5%)、產(chǎn)褥感染(1.5%)、尿潴留(6.1%)發(fā)生比例略高于自然破膜組(3.9%、2.6%、0.0%和3.9%),上述組間比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。人工破膜組經(jīng)陰道分娩新生兒1 min Apgar評(píng)分(7.92±0.97)、產(chǎn)瘤發(fā)生率(21.2%)略高于自然破膜組[(7.77±0.99)、14.3%],新生兒窒息率(7.6%)略低于自然破膜組(10.4%),上述圍產(chǎn)兒結(jié)局差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論自由體位待產(chǎn)模式下,活躍期予人工破膜較自然破膜并未明顯減少產(chǎn)程時(shí)間,但卻增加了因枕位異常、宮內(nèi)窘迫等造成的剖宮產(chǎn)率;建議正常產(chǎn)程中活躍期不要行人工破膜干預(yù)。
[Abstract]:Objective to compare and analyze the maternal and infant outcome of artificial membrane breaking and natural membrane breaking combined with free position, and to explore a more safe and effective mode of labor process management. Methods 170 pregnant women admitted from June 2014 to July 2015 in the affiliated Hospital of Tibet University for nationalities were studied. According to the method of membrane breaking, 85 cases were divided into artificial rupture group (85 cases) and natural membrane breaking group (85 cases). The difference between delivery outcome and neonatal outcome was compared between the two groups. Results the proportion of cesarean section in the artificial rupture group was 22. 4% higher than that in the natural rupture group because of the abnormal occipital position. The time of the first stage of labor was 537.8 鹵50.3 min, the time of the second stage of labor was 35.8 鹵9.1 min, the volume of blood loss was 182.4 鹵37.5 ml at 2 h postpartum, which was slightly less than that of the group of natural rupture of membrane (549.5 鹵57.3 min 38.5 鹵10.5)min and 190.7 鹵40.4 ml); the cervical tear was 4.5 鹵4.5ml; the puerperal infection was 1.5m; the urine retention was 6.1ml). The cases were slightly higher than those in the natural membrane breaking group (P < 0.01), and the difference between the two groups was not statistically significant (P 0.05). The rate of neonatal asphyxia and neonatal asphyxia in artificial rupture group was slightly lower than that in natural rupture group (7.92 鹵0.97 Apgar score 7.92 鹵0.97 鹵7.92 鹵0.97 and 21.2g / kg), respectively, and the neonatal asphyxia rate was slightly lower than that of natural rupture group (10.4%). There was no significant difference in the perinatal outcome between the two groups (P 0.05). Conclusion in the mode of waiting for labor in free posture, artificial rupture of membrane in active period does not significantly reduce the time of labor process, but it increases the rate of cesarean section caused by occipital abnormality and intrauterine distress. It is suggested that artificial membrane breaking intervention should not be performed during the active stage of normal labor.
【作者單位】： 西藏民族大學(xué)附屬醫(yī)院產(chǎn)科;
【分類號(hào)】：R714

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