改良娩肩法应用于肩难产产妇中的效果分析

摇 摇 肩难产作为产科高发分娩并发症,其主要指产 妇在分娩胎儿时其肩膀卡于产妇骨盆出口,阻碍分 娩进程[1] 。 有相关调查结果显示,肩难产的发生率 为 0. 2% ~ 2. 0% [2] 。 虽然其发生率不高,但因其发 生前并无预兆,若未得到及时干预会对产妇及胎儿 造成严重影响[3] 。 改良娩肩法指的是在宫缩期缓 慢分娩患儿头部后,助产士在下次宫缩到来后通过 轻压胎儿颈部的前拉力并指导产妇利用腹压,促进 胎儿肩部娩出的方式[4 -5] 。 本研究对我院收治的行 阴道分娩的产妇给予改良娩肩法,对比常规接产方
Effect analysis of the modified shoulder delivery in the application of shoulder dystocia
LIU Yan,SUN Jin鄄yan,WANG Li ( Department of Obstetrics,Nanjing First Hospital,Nanjing Medical University,Nanjing Jiangsu 210006,China)
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J Bengbu Med Coll,January 2020,Vol. 45,No. 1
[ 文章编号] 1000鄄2200(2020)01鄄0128鄄03
改良娩肩法应用于肩难产产妇中的效果分析
·护理学·
刘摇 雁,孙金燕,万摇 丽
[ 摘要] 目的:探讨改良娩肩法应用于肩难产产妇中的效果。 方法:肩难产产妇 84 例根据接产方法不同分为 2 组,对照组 41 例 采用常规接产法,观察组 43 例采用改良娩肩法。 对比 2 组产妇并发症发生率、产妇会阴裂伤程度、新生儿 Apgar 评分、新生儿 产伤发生率情况。 结果:观察组产妇产后总并发症发生率低于对照组( P < 0. 05) ;观察组会阴裂伤程度与对照组相比差异无 统计学意义( P > 0. 05) ;观察组新生儿 Agpar 评分高于对照组,新生儿窒息率低于对照组( P < 0. 05) ;观察组新生儿产伤总发 生率低于对照组( P < 0. 05) 。 结论:改良娩肩法应用于肩难产产妇中可显著降低产后并发症发生率和新生儿窒息率,尽可能 减少新生儿产伤发生,保障分娩顺利进行,值得推广。 [ 关键词] 肩难产;改良娩肩法;产妇;并发症;新生儿 Apgar 评分 [ 中图法分类号] R 714. 4摇 摇 摇 [ 文献标志码] A摇 摇 摇 DOI:10. 13898 / j. cnki. issn. 1000鄄2200. 2020. 01. 033
[ Abstract] Objective:To explore the effects of the modified shoulder delivery in the application of shoulder dystocia. Methods:A total of 84 cases with shoulder dystocia were divided into the control group(41 cases) and observation group(43 casmethods of delivery. The control group was treated with conventional delivery, and the observation group was treated with modified shoulder delivery. The incidence rate of maternal complications, degree of maternal perineal laceration, neonatal Apgar score and incidence rate of neonatal birth injury were compared between two groups. Results:The total incidence rate of postpartum complication in observation group was lower than that in control group( P < 0. 05) . There was no statistical significance in the degree of perineal laceration between two groups( P > 0. 05) . The Agpar score and neonatal asphyxia rate in observation group were higher and lower than that in control group,respectively( P < 0. 05) . The total incidence rate of birth injury in observation group was lower than that in control group( P < 0. 05) . Conclusions:The modified shoulder delivery can significantly reduce the incidence rates of postpartum complications and neonatal asphyxia,minimize the incidence of neonatal birth injury, and ensure the smooth delivery of childbirth. It is worthy of promotion. [ Key words] shoulder dystocia;modified shoulder delivery;puerpera;complication;neonatal Apgar score