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目的分析头位剖宫产术中导致娩头困难的因素及相应处理对策。方法对2008年12月至2009年12月总住院分娩人数1686例,头位剖宫产术668例,其中剖宫产术中84例娩头困难病例进行回顾性分析。结果剖宫产术娩头困难发生率为12.57%。主要原因为:①胎头深嵌;②胎头高浮;③胎头位置不正;④麻醉效果差;⑤切口相对较小;⑥子宫切口位置选择不当;⑦医源性因素。剖宫产术中娩头困难增加了新生儿窒息、产伤、子宫切口裂伤、大出血等并发症。结论迅速顺利的娩出胎头,是剖宫产手术的关键,掌握剖宫产术娩头困难的处理技巧,做好术前评估和紧急应对措施,确保母婴安全。
Objective To analyze the factors leading to difficulties in the delivery of cesarean section and the corresponding treatment strategies. Methods From December 2008 to December 2009, the total hospital delivery number of 1686 cases, the first cesarean section in 668 cases, of which 84 cases of cesarean delivery difficult head was retrospectively analyzed. Results Cesarean delivery head difficulties rate was 12.57%. The main reasons are: ① fetal head deep inlay; ② fetal head floating high; ③ fetal head position is not correct; ④ poor anesthetic effect; ⑤ relatively small incision; ⑥ uterine incision position inappropriately selected; ⑦ iatrogenic factors. Cesarean delivery head difficulties increased neonatal asphyxia, birth trauma, uterine incision laceration, bleeding and other complications. Conclusion The rapid and smooth delivery of the fetal head is the key to cesarean section operation. To master the difficult delivery techniques of cesarean delivery and make preoperative evaluation and emergency response measures to ensure the safety of mother and baby.