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目的:探讨单胎头位足月初产妇经阴道分娩过程中,对产力实施数字化动态测量的临床应用价值。方法:选择单胎头位初产妇308例,参照业界的普遍做法,根据分娩方式分为经阴道分娩组(观察组)227例和剖宫产组(对照组)81例。在经阴道分娩第一产程观察过程中测量胎头下降推力;严格掌握剖宫产手术指征,在确保胎儿安全的前提下充分试产,产程无进展后行剖宫产术。当宫口开大3cm时行人工破膜,并开始监测胎头下降推力;以15min为时间单位分别计算该时间段宫缩力的子宫有效收缩面积积分(UAI)值和Montevideo单位(MU)值。比较两组产程进展过程中胎头下降推力和宫缩力测量情况。结果:宫口开大3cm时,两组胎头下降推力差异不显著(P>0.05);宫口开大5cm、8cm时,观察组胎头下降推力均显著大于对照组(P<0.05);宫口开大10cm时,观察组胎头下降推力达到峰值,对照组在宫口开大10cm前施行剖宫产手术。宫口分区在3~5cm、5~8cm时,观察组宫缩力的UAI值和MU值均显著高于对照组(P<0.05)。结论:胎头下降推力和宫缩力数字化动态测量,对于单胎头位足月经阴道分娩产程进展评估具有重要价值,宫口开大5cm和8cm可作为产程进展过程中产力监测的关键时间节点。
Objective: To investigate the clinical application value of digitized dynamic measurement of the productivity of single-term headpartum during full-term vaginal delivery. Methods: A total of 308 primiparous women with single fetal head were selected. According to the common practice in the industry, 227 cases of vaginal delivery group (observation group) and 81 cases of cesarean section group (control group) were divided according to mode of delivery. During vaginal delivery during the observation of the first stage of labor to measure the decline of fetal head thrust; strict cesarean section indications, to ensure the safety of the fetus under the premise of full trial production, labor progress without cesarean section. When the cervix 3cm large open artificial rupture, and began to monitor the fetal head descending thrust; 15min as a unit of time were calculated for the time period uterine contractile force effective area of contraction (UAI) value and Montevideo unit (MU) value . During the course of labor, the decline of fetal head thrust and contractility were compared between the two groups. Results: When the cervix was opened for 3 cm, there was no significant difference in the descending thrust between the two groups (P> 0.05). When the cervix was opened for 5 cm and 8 cm, the descending thrust of the fetal head in the observation group was significantly greater than that of the control group (P <0.05). Miyaguchi open large 10cm, the observation group fetal head thrust reached its peak, the control group in the cervix open 10cm before the implementation of cesarean section. The uterine contractions in the 3 ~ 5cm, 5 ~ 8cm, the observation group of UAI value and MU value were significantly higher than the control group (P <0.05). Conclusions: The digital dynamic measurement of fetal descending thrust and contractility is of great value for evaluating the progress of labor during vaginal delivery with single fetus. Mouth opening 5 cm and 8 cm can be used as the key time points for the monitoring of labor during the progress of labor.