施琰

[摘要]目的 分析低位產钳助产术应用于产科分娩过程中的效果及其并发症。方法 选取2014年3月～2016年10月我院收治的头位难产产妇89例为研究对象，根据助产方式不同将其分为观察组（n=44例）与对照组（n=45例）。其中，观察组44例产妇进行低位产钳助产术分娩，对照组45例产妇行剖宫产术分娩。观察比较两组不同助产方式产妇产后出血、产褥感染、软产道损伤等并发症的发生情况及两组新生儿面部擦伤、头皮血肿及新生儿窒息的发生情况等，比较两组产妇住院时间及抗生素使用情况。结果 观察组产妇产后出血、产褥感染及软产道损伤的发生率明显低于对照组，差异有统计学意义（P<0.05）；与对照组比较，观察组新生儿面部擦伤、头皮血肿及新生儿窒息的发生率明显低于对照组，差异有统计学意义（P<0.05）；与对照组比较，观察组产妇住院时间明显短于对照组，产妇产后使用抗生素比例也明显低于对照组，差异有统计学意义（P<0.05）。结论 与剖宫产术比较，低位产钳助产术可有效降低产妇及新生儿产后并发症的发生率，改善母婴预后效果，缩短住院时间，降低抗生素药物的使用，提高安全分娩，值得临床推广应用。

[关键词]低位产钳助产术；产科；头位难产；阴道分娩

[中图分类号] R719.6 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0094-03

Analysis on the application effect and complications of midwifery by low position forceps in obstetric delivery

SHI Yan

Department of Gynecology and Obstetrics，Wuxi Second People′s Hospital，Jiangsu Province，Wuxi 214002，China

[Abstract]Objective To analyze the effect and complications of midwifery by low position forceps in the process of obstetric delivery.Methods 89 puerpera with dystocia of cephalic presentation who were admitted to our hospital from March 2014 to October 2016 were selected as the study subjects.According to different modes of midwifery，the patients were divided into the observation group （n=44） and the control group （n=45）.Among them，44 puerpera in the observation group were given midwifery pregnancy by low position forceps.45 puerpera in the control group were given maternal cesarean delivery.The incidence of complications such as postpartum hemorrhage，puerperal infection，soft birth canal injury，as well as the occurrence of neonatal facial abrasions，scalp hematoma and neonatal asphyxia in the two groups of puerpera receiving different modes of midwifery were observed and compared.The length of stay and application of antibiotics of puerpera were compared between the two groups.Results The incidence rate of postpartum hemorrhage，puerperal infection and soft birth canal injury after the surgery in the observation group was significantly lower than that in the control group，the differences were statistically significant （P<0.05）；compared with the control group，the incidence rate of neonatal facial abrasion，scalp hematoma and neonatal asphyxia was significantly lower in the observation group than in the control group，the differences were statistically significant （P<0.05）；compared with the control group，the length of stay in the observation group was significantly shorter than that in the control group，and the proportion of postpartum antibiotics use was significantly lower than that in the control group，the differences were statistically significant （P<0.05）.Conclusion Compared with cesarean section，midwifery by low position forceps can effectively reduce maternal and neonatal postpartum complications，improve the effect of maternal and child prognosis，shorten the hospital stay，reduce the use of antibiotics，and improve the safe delivery，which is worthy of clinical popularization and application.endprint

[Key words]Midwifery by low position forceps；Obstetrics；Dystocia of cephalic presentation；Vaginal delivery

头位难产主要是指因胎儿胎头位置或胎头俯屈不良所导致的分娩困难[1]。对于出现难产的孕妇多进行剖宫产或产钳助产术。根据胎儿在盆腔内位置的不同，产钳术分为高、中、低位产钳助产，其中高位及中位产钳由于在手术中操作较为困难，极易引发母婴损伤，术后并发症多，逐渐被剖宫产所替代，且随着剖宫产术安全系数的提升越来越被重视，受到孕妇和临床医生的青睐。然而较多研究数据显示，剖宫产术会增加胎儿窒息等并发症的发生，并非最安全的分娩方式，特别是对于头位难产孕妇，胎位不正本身就存在较大的安全隐患。如果能够采用缩短分娩时间、确保胎儿安全及减轻孕妇损伤的分娩方式，无疑是处理头位难产孕妇分娩的最好方式[2-4]。……