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目的:分析剖宫产术中胎头娩出困难的原因和损伤发生情况,探讨相应的处理方法。方法:选择2008年1月～2011年4月期间在东阳市妇幼保健院进行剖宫产术中胎头娩出困难120例患者作为实验组,随机选择同期行剖宫产术中胎头正常娩出的120例作为对照组,两组麻醉方式和手术方式相同,术后观察发生胎头娩出困难的原因和损伤发生情况。结果:胎儿因素、子宫因素、切口因素和医源性因素导致的胎头娩出困难分别为75例、8例、17例和20例,实验组的损伤发生率为69.2%,高于对照组的12.5%,两者比较具有统计学差异(P<0.05)。新生儿方面,实验组出现新生儿窒息19例,颅内出血1例,显著低于对照组(P<0.05)。结论:针对导致胎头娩出困难发生的不同原因,采取相应的处理方法,可确保母婴健康,提高剖宫产手术的质量。
OBJECTIVE: To analyze the causes and injuries of fetal head during cesarean section and discuss the corresponding treatment methods. Methods: From January 2008 to April 2011 in Dongyang Maternal and Child Health Hospital for cesarean section in 120 cases of fetal head delivery difficulties as experimental group, randomly selected during the same period of cesarean section in the normal delivery of fetal head 120 cases served as the control group. The anesthesia and operation methods of the two groups were the same, and the causes of the difficult delivery of fetal head and the occurrence of injury were observed after operation. Results: Fetal factors, uterine factors, incision factors and iatrogenic factors caused fetal head delivery difficulties were 75 cases, 8 cases, 17 cases and 20 cases, the experimental group of injury rate was 69.2%, higher than the control group 12.5% respectively, with statistical significance (P <0.05). Newborns, the experimental group of neonatal asphyxia in 19 cases, intracranial hemorrhage in 1 case, significantly lower than the control group (P <0.05). Conclusion: In view of the different causes leading to the difficult delivery of fetal head, appropriate treatment can be taken to ensure the health of maternal and infant and improve the quality of cesarean section.