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目的探讨手转胎头术最佳时机的选择。方法选择2010年1月至2011年12月鹿寨县中医医院收治的130头位难产产妇,根据宫口扩张大小进行手转胎术的时机分A、B、C组,对比分析三组的转位成功率、阴道分娩率、剖宫产率、新生儿出生1 min Apgar评分、阴道分娩平均时间、产后出血量等指标。结果 C组手转胎头成功率为94.5%,显著高于A组(67.4%)及B组(71.8%);剖宫产率为5.5%,低于A组(32.6%)及B组(28.2%);新生儿出生1 min Apgar评分为(9±1)分,优于A组的(7±2)分及B组的(7±2)分;经阴道分娩平均时间为(409±70)min,显著短于A组的(509±102)min及B组的(509±122)min;产后出血(148±56)ml,明显少于A组的(208±63)ml及B组的(213±68)ml。结论头位难产适时给予手法旋转胎头,纠正胎头方向,可缩短产程,使胎儿顺利娩出,提高了自然分娩率,同时有效降低分娩过程中对母儿的损伤,提高产科质量。
Objective To explore the best timing of hand-turn fetal surgery. Methods 130 head dystocia patients admitted to Luzhai Chinese Medicine Hospital from January 2010 to December 2011 were divided into groups A, B and C according to the timing of hand twins according to the size of the cervix. The transposition of the three groups Success rate, vaginal delivery rate, cesarean section rate, Apgar score 1 minute after birth, average time of vaginal delivery, postpartum hemorrhage and other indicators. Results The success rate of manual fetal caries in group C was 94.5%, significantly higher than that in group A (67.4%) and group B (71.8%). The rate of cesarean section was 5.5%, lower than that in group A (32.6%) and group B 28.2%); Apgar score at 1 minute after birth was (9 ± 1) points better than (7 ± 2) points in group A and (7 ± 2) points in group B; mean time of vaginal delivery was (409 ± 70 ± min) was significantly shorter than that of group A (509 ± 102) min and group B (509 ± 122) min; postpartum hemorrhage (148 ± 56) ml was significantly less than that of group A Group (213 ± 68) ml. Conclusion Head dystocia given manual rotation of the fetal head, correct fetal head direction, can shorten the labor process, so that the fetus delivered smoothly, improve the natural delivery rate, while reducing maternal and childbirth during childbirth and improve the quality of obstetrics.