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目的:探讨新式剖宫产术中胎头娩出困难的相关因素和预防处理对策,最大限度地减少胎头娩出困难对母儿造成的影响。方法:对2007年6月～2010年6月新式剖宫产2 068例行回顾性分析,把术中发生娩头困难的116例作为观察对象,分析娩头困难原因。结果:胎头娩出困难患者中,胎头高浮48例,占41.3%,麻醉不满意25例,占21.6%,胎头深嵌20例,占17.2%,子宫切口过小8例,占6.9%,子宫切口位置选择不当2例,占1.7%,术者经验不足8例,占6.9%,产妇腹壁肥厚5例,占4.3%。结论:剖宫产术中娩胎头是关键,术前全面详细检查产妇及胎儿情况,充分估计各种娩头困难的原因和熟悉其处理方法,正确把握剖宫产的时机,合理选择手术切口,满意的麻醉与娴熟的手术技巧能有效避免取头困难。
Objective: To explore the new caesarean section of fetal head delivery difficulties related factors and preventive measures to minimize the impact of fetal head delivery difficulties on the mother and child. Methods: A retrospective analysis of 2 068 cases of new cesarean section from June 2007 to June 2010 was conducted. 116 cases with difficult delivery head during operation were analyzed retrospectively. Results: Among the patients with difficult fetal head delivery, 48 cases of fetal head floating up (41.3%), 25 cases of unsatisfactory anesthesia (21.6%), 20 cases of fetal head deep embedding (17.2%) and 8 cases of uterine incision %, The location of uterine incision in 2 cases inappropriate choice, accounting for 1.7%, surgeon experience less than 8 cases, accounting for 6.9%, maternal abdominal wall hypertrophy in 5 cases, accounting for 4.3%. Conclusion: Cesarean section in the delivery of fetal head is the key preoperative comprehensive and detailed examination of maternal and fetal conditions, fully estimate the causes of various head difficulties and familiar with its handling methods, correctly grasp the timing of cesarean section, a reasonable choice of surgical incision , Satisfactory anesthesia and skilled surgical skills can effectively avoid the difficulty of taking the lead.