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目的探讨再次剖宫产中有利于胎头娩出的方法。方法选择再次剖宫产产妇180例,随机分成治疗组(92例)与对照组(88例),治疗组全部用压肠板协助胎头娩出,对照组用手助方法娩出胎儿,两组结果进行比较。结果治疗组胎儿均顺利娩出,自切皮至胎儿娩出的平均时间6.26 min[(6.0±0.5)min],术中平均出血180.68 ml[(125.5±12.50)ml],无新生儿窒息及子宫切口延长和撕裂。对照组自切皮至胎儿娩出的平均时间8.68 min[(8.4±0.6)min],术中平均出血224.46 ml[(220.50±10.50)ml],两组相比差异有统计学意义(P<0.05)。对照组出现新生儿窒息8例,新生儿颅内出血2例,子宫切口撕裂和倒“T”切口各4例,产钳协助胎头娩出4例。结论再次剖宫产子宫腹部粘连,术野相对较小,胎头高浮,麻醉效果的好坏均可影响胎头娩出,利用压肠板协助胎头娩出效果良好,能有效缩短胎头娩出时间,减少并发症,且使用方便、安全,值得临床推广应用。
Objective To explore the second cesarean section is conducive to fetal head delivery method. Methods 180 cases of cesarean section were selected and randomly divided into treatment group (n = 92) and control group (n = 88). All patients in the treatment group were given pressure-gut tablet to assist the birth of the fetal head. The control group was delivered by hand. Compare. Results In the treatment group, all the fetuses were successfully delivered. The mean time from the incision to the fetus was 6.26 min [(6.0 ± 0.5) min], and the average intraoperative bleeding was 180.68 ml [(125.5 ± 12.50) ml]. There was no neonatal asphyxia and uterine incision Prolong and tear. In the control group, the average time from skin incision to fetus was 8.68 min [(8.4 ± 0.6) min], mean intraoperative blood loss was 224.46 ml [(220.50 ± 10.50) ml], the difference was statistically significant (P <0.05 ). In the control group, 8 cases of neonatal asphyxia, 2 cases of neonatal intracranial hemorrhage, 4 cases of uterine incision torn and inverted “T ” incision in 4 cases, forceps assisted fetal head delivery. Conclusion Cesarean section abdominal adhesions again, the relatively small surgical field, the fetal head floating high, the effect of anesthesia can affect the fetal head was delivered, the use of pressure intestinal board to help fetal head delivered good results, can effectively shorten the fetal head delivery time , Reduce complications, and easy to use, safe, worthy of clinical application.