摘要
目的分析新产程标准对产钳助产的相关因素及母儿结局的影响。方法采用回顾性研究的方法,选择2008年和2015年北京市海淀区妇幼保健院因第二产程延长行产钳助产的产妇302例,其中2008年旧产程标准产钳助产99例,2015年新产程标准产钳助产203例,比较产程标准不同,产钳助产的相关因素和母婴结局的差异。结果 (1)旧产程标准下,第二产程延长产钳助产比例为1.72%,新产程标准为2.55%,比较差异有统计学意义(χ~2=10.73,P<0.05);(2)新旧产程标准下,因第二产程延长行产钳助产中肩难产、产褥感染、新生儿Apgar评分和产后母亲血红蛋白下降值之间差异无统计学意义。新产程标准下,产钳助产尿潴留的发生比例比旧产程标准高出5倍(χ~2=7.07,P=0.01),但发生软产道裂伤(χ~2=4.86,P=0.04)和新生儿并发症的比例更低(χ~2=10.43,P=0.00),产后住院的时间也更短(t=3.33,P=0.00)。结论新产程标准实施后,产钳助产母儿部分并发症可降低,但应注意预防产后尿潴留的发生。
Objective To explore the related factors of forceps delivery after use of new labor criteria and maternal and neonatal outcomes.Methods A total of 302 women receiving forceps delivery because of prolonged second stage of labor were collected from 2008 and 2015 in Haidian District Maternal and Child Health Hospital with retrospective study method. There were 99 cases recruited with Friedman labor criteria and 203 cases with new labor criteria. Relevant factors and maternal and neonatal outcomes of forceps delivery with differnt labor criteria were compared. Results The incidence of forceps delivery resulting from prolonged second stage increased after use of new labor criteria（ 2. 55% vs 1. 72%） with statsitical signficance（ χ^2= 10. 73,P〈0. 05）. There was no significant difference in incidence of shoulder dystopia and puerperal infection,Agars score of newborn and postnatal hemoglobin descend value of woman between new labor criteria and Friedman labor criteria. With new labor criteria the incidence of urinary retention in forceps delivery was 5 times higher than that with Friedman labor criteria（ χ^2= 7. 07,P = 0. 01）,but the incidence of soft birth canal laceration（ χ^2= 4. 86,P = 0. 04） and complications of newborns（ χ^2= 10. 43,P = 0. 00） was lower and postnatal hospital stay was shorter（ t = 3. 33,P = 0. 00）. Conclusion Application of new labor criteria reduces the incidence of maternal and neonatal complications in forceps delivery,but measures should be taken to prevent urinary retention.
出处
《中国妇幼健康研究》
2017年第10期1181-1183,共3页
Chinese Journal of Woman and Child Health Research
