摘要
目的探讨巨大儿产科处理的合理性以及肩难产对母儿副损伤的技术防范。方法回顾性分析笔者所在医院2006年～2009年210例巨大儿分娩方式及结局。结果210例巨大儿，体重34000g，其中剖宫产137例，剖宫产率为65．24％（137／210）；产前诊断巨大儿180例，剖宫产123例，剖宫产率为68．33％（123／180）；阴道分娩57例，占31．67％。产后出血率：巨大儿剖宫产为20．44％，巨大儿阴道分娩为12．33％。新生儿重度窒息率：剖宫产为2．19％，阴道分娩为2．74％，阴道分娩肩难产12例，其中新生儿产伤4例。结论对巨大儿的孕妇，不能常规选择剖宫产，也不能盲目从于阴道试产，应根据不同的情况选择合适的分娩方式。一旦发生肩难产，不要惊慌，尽量缩短胎肩娩出时间是新生儿存活的关键，按正规步骤恰当处理，可最大限度的减少分娩对母婴的损伤。
Objective To investigate the rationality of obstetric processing of giant baby and the technical prevention of the fetomaternal Para - injury by shoulder dystoeia. Methods To look back and analyze 210 cases of the delivery mode and end - results of giant baby from 2006 to 2009 in our hospital. Results 210 cases of giant baby, whose body weight is more than or equal to 4 000 g, includes 137 cases of Caesarean section, i.e. the rate of Caesarean is 65. 24% （137/210） ; 180 cases of giant baby on antenatal diagnosis includes 123 cases of Caesarean section, i.e. the rate of Caesarean is 68. 33% （1：23/180） ;57 cases of Vaginal delivery account 31.67%. The rate of postpartum hemorrhage： Cacsarean section of giant baby accounts 20.44% ;vaginal delivery of giant baby accounts 12. 33%. The severe apnoea rate of neonat： Caesarean section 2. 19% ;vaginal delivery 2. 74% ;shoulder dystoeia in vaginal delivery accounts 12 cases, including 4 cases of neonat birth injury. Conclusion Caesarean section can＇t routinely be chosen for a pregnant woman with a giant baby, nor can vagina trial labor be followed blindly. We should choose an appropriate delivery mode according to various conditions. In case shoulder dystocia occurs, don＇t panic. Try to shorten the time of shoulder delivery is the key to the survival of the neonat, and process it properly can reduce to the utmost the injury of the delivery to the mother and baby.
出处
《中外医学研究》
2010年第10期11-12,共2页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
巨大儿
分娩方式
肩难产
技术防范
Giant baby
Delivery mode
Shoulder dystocia
Technical prevention
