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目的:探讨阴道助产掌临床应用指征及其对减少母婴损伤的效果。方法:2013年6~12月对60例行阴道分娩的产妇应用阴道助产掌,并与同期60例行胎头吸引助产、60例应用产钳助产的产妇进行对比,分析3种助产方式的母婴损伤情况。结果:阴道助产掌组操作时间、总产程、产妇术中出血量及术后出血量显著少于胎头吸引组及产钳助产组,差异均有统计学意义(P<0.05)。产钳助产组术中出血量及术后出血量高于胎头吸引组,差异均有统计学意义(P<0.05)。阴道助产掌组软产道损伤、阴道壁裂伤、宫颈裂伤、会阴Ⅲ度裂伤、产后出血、会阴水肿及尿潴留发生率显著低于胎头吸引组及产钳助产组,差异均有统计学意义(P<0.05);产钳助产组软产道损伤、阴道壁裂伤、宫颈裂伤、会阴Ⅲ度裂伤及产后出血发生率高于胎头吸引组,差异均有统计学意义(P<0.05)。阴道助产掌组新生儿头部挫伤、重度窒息、头颅血肿、吸入性肺炎、臂丛神经损伤及锁骨骨折发生率显著低于胎头吸引组及产钳助产组,而单次助产成功率低于产钳助产组,差异均有统计学意义(P<0.05);产钳助产组新生儿头部挫伤、臂丛神经损伤及锁骨骨折发生率高于胎头吸引组,差异均有统计学意义(P<0.05)。结论:阴道助产掌是一种操作简单、易于掌握、安全有效、对母婴损伤小、助产快的新型助产技术,在一定条件下可替代产钳助产术及胎头吸引术,值得临床应用。
Objective: To investigate the indications of clinical application of vaginal midwifery and its effect on reducing maternal and infant injuries. Methods: From June to December 2013, 60 vaginal deliveries were applied to the vagina delivery maternity and compared with 60 fetuses in the same period to attract midwifery and 60 births to forceps delivery. Three kinds of midwifery Way of maternal and child injury. Results: The operation time, total labor, maternal blood loss and postoperative bleeding volume in vaginal delivery group were significantly less than those in fetal suction group and forceps midwifery group (P <0.05). The forceps midwifery group bleeding volume and postoperative bleeding was higher than the fetal head suction group, the difference was statistically significant (P <0.05). The incidences of soft birth canal injury, vaginal wall laceration, cervical laceration, third degree perineal laceration, postpartum hemorrhage, perineal edema and urinary retention were significantly lower in the vaginal midwifery group than those in the fetal head suction group and the forceps midwifery group (P <0.05). The incidences of soft birth canal injury, vaginal wall laceration, cervical laceration, third degree perineal laceration and postpartum hemorrhage in the forceps-assisted group were significantly higher than those in the fetal head suction group (P <0.05) P <0.05). The incidence of head contusion, severe asphyxia, head hematoma, aspiration pneumonia, brachial plexus injury and clavicular fracture in the vaginal midwifery group was significantly lower than that in the fetal head suction group and forceps midwifery group, while the success rate of single midwifery (P <0.05). The rate of head contusion, brachial plexus injury and clavicular fracture in neonates with forceps-assisted labor group was higher than that in fetal head traction group, the difference was statistically significant Significance (P <0.05). Conclusion: The vaginal midwifery is a new type of midwifery technology that is easy to operate, easy to grasp, safe and effective, with less damage to maternal and infant and faster midwifery. Under certain conditions, it is worthwhile to replace pliers forceps and fetal head aspiration Clinical application.