目的探讨产程中体位改变联合徒手旋转胎头对枕后位分娩结局的影响。方法选择2011年1月—2015年1月收治的121例初产妇,随机分为对照组63例和观察组58例,对照组采用手抱膝改变体位处理,观察组采用手抱膝改变体位联合徒手旋转胎头处理,比较两组产妇产程时间、自然分娩成功率、产妇阴道损伤及新生儿窒息情况,并进行统计学分析。结果观察组产妇在经过体位改变联合徒手旋转胎头后,阴道分娩率为76.4%高于对照组的58.7%,产程时间低于对照组,新生儿Apgar评分及窒息率均低于对照组,差异有统计学意义(均P<0.05)。结论产程中体位改变联合徒手旋转胎头,可改善胎头以最佳的径线和头盆关系使胎儿以枕前位顺利娩出,降低难产及剖宫产率。 Objective To investigate the effect of changing body position combined with hand-free rotation of the fetal head on post-occipital delivery. Methods 121 cases of primipara were selected from January 2011 to January 2015 and were randomly divided into control group (63 cases) and observation group (58 cases). The control group was treated by hand and tuck knees to change position, and the observation group Rotation of the fetal head by hand, the two groups of maternal labor time, the success rate of natural delivery, maternal vaginal injury and neonatal asphyxia, and statistical analysis. Results In the observation group, vaginal delivery rate was 76.4% in the observation group and 58.7% in the control group after birth position change combined with hand-free rotation of the fetal head, and the duration of labor was lower than that of the control group. The neonatal Apgar score and asphyxia rate were lower than those in the control group There was statistical significance (all P <0.05). Conclusion The combination of body position changes and hand rotation of the fetal head can improve the fetal head with the best diameter line and the relationship between the head of the fetus to the anterior occipital smooth delivery and reduce the rate of dystocia and cesarean section.