目的探讨头位难产试产至宫口开全改行剖宫产术,术中取胎头困难,采用两种方式娩出胎儿对新生儿预后的影响。方法对我科自2008年1月至2011年12月所发生的头位难产试产病例,胎心监护无明显异常,羊水无明显粪染,均宫口开全,胎头在S+2左右,下降阻滞,胎头干涩者改行剖宫产术,术中取胎头困难50例,分为A、B两组各25例,A组:助手阴道上顶胎头术者娩出胎儿25例,B组以胎足牵引娩出胎儿25例,比较两组新生儿窒息、颅内出血及产伤的发病率及预后的情况。结果 B组新生儿窒息、颅内出血及产伤的发病率均明显低于A组,且新生儿预后明显好于A组。结论当头位难产试产至宫口开全,胎头在S+2左右,下降阻滞,胎头干涩者改行剖宫产术中取头困难时以胎足牵引娩出胎儿,可明显降低新生儿并发症的发病率,实为一种较好的方法 。 Objective To investigate the effect of headpart dystocia trial to cesarean section on cesarean section with cesarean section. Method of our department from January 2008 to December 2011 occurred in the first bit of hard labor pilot cases of fetal heart rate monitoring no significant abnormalities, amniotic fluid without meconium stained, all open mouth Palace, fetal head in the S + 2 or so , Decreased block, dry head were diverted cesarean section, intraoperative fetus difficult to take 50 cases, divided into A, B two groups of 25 cases, A group: assistant vaginal top fetal operation who delivered the fetus in 25 cases In group B, 25 fetuses were delivered by fetal foot traction. The incidence and prognosis of neonatal asphyxia, intracranial hemorrhage and birth trauma were compared between the two groups. Results The incidence of neonatal asphyxia, intracranial hemorrhage and birth trauma in group B were significantly lower than those in group A, and the prognosis of neonates was significantly better than that of group A. Conclusion When the first bit of dystocia trial to the cervix to open the whole, fetal head in the S +2 or so, down block, dry head were diverted cesarean section to take the first difficulty in fetus traction when fetus, can significantly reduce the newborn The incidence of complications, in fact, is a better method.