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目的:探讨腹壁横切口剖宫产术中胎头深嵌和胎头高浮时胎头娩出的最佳处理方法。方法:回顾性分析2007年1月～2010年1月间124例胎头深嵌和胎头高浮孕妇腹壁横切口剖宫产术胎头娩出困难产妇的临床资料。根据不同手术处理方法分成两组,Ⅰ组:根据胎头深嵌和胎头高浮情况灵活采取多种手术技巧;Ⅱ组:采用传统腹壁横切口剖宫产术。对两组胎头娩出时间、娩头困难发生率、新生儿窒息率、术中出血量多方面进行比较。结果:两组新生儿体重及头围的比较无统计学差异(P>0.05)。切皮至胎头娩出时间、娩头困难发生率、新生儿窒息率、术中出血量,Ⅰ组各项数据明显低于Ⅱ组(P<0.05)。结论:腹壁横切口剖宫产胎头深嵌和胎头高浮的处理方法各有不同,术前应充分估计胎头娩出的难易程度,术中根据不同原因采取不同的防治措施,加强术者与助手的配合,降低母婴并发症的发生率。
Objective: To investigate the optimal treatment of fetal head embedded in the abdominal wall transverse incision cesarean section and fetal head high floating fetal head. Methods: A retrospective analysis of 124 cases of fetal head deep embedding and fetal head high floating during January 2007 ~ January 2010 abdominal incision cesarean section of the fetal head delivery difficult clinical data. According to different surgical treatment methods are divided into two groups, Ⅰ group: according to the fetal head deep inlay and fetal head flexibly take a variety of flexible surgical techniques; Ⅱ group: the traditional abdominal transverse incision cesarean section. The two groups of fetal head delivery time, delivery head difficulties, neonatal asphyxia, blood loss in many aspects were compared. Results: There was no significant difference in body weight and head circumference between the two groups (P> 0.05). Incision to the fetal head delivery time, delivery head difficulties, neonatal asphyxia, intraoperative blood loss, all data in group Ⅰ was significantly lower than the group Ⅱ (P <0.05). CONCLUSIONS: There are differences in the treatment of deep fetal head embedding and high fetal head floating in abdominal transverse incision, and the ease of fetal head delivery should be fully estimated before operation. Different prevention and treatment measures should be taken during surgery to strengthen the operation With the assistants and reduce the incidence of maternal and child complications.