调整宫缩下屈髋手转胎头纠正持续性枕横位和枕后位165例分析

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[摘要] 目的 探讨调整宫缩下屈髋手转胎头在持续性枕横位、枕后位的临床效果。 方法 对我院2010年3月～2012年2月165例持续性枕横位、枕后位在调整宫缩下屈髋配以手转胎头的临床资料进行回顾分析。 结果 165例持续性枕横位和枕后位产妇，在调整宫缩下屈髋配以手转胎头后经阴道自然分娩126例，胎吸助产11例，成功率为83%；经上述处理无效，剖宫产28例，占17%。所有新生儿均无死亡，产妇也未发生严重并发症。 结论 持续性枕横位、枕后位通过调整宫缩下屈髋配以手转胎头能有效缩短产程，减少产妇痛苦，对胎儿损伤小，降低剖宫产率，临床效果明显，值得推广。

[关键词] 持续性枕横位和枕后位；调整宫缩；屈髋；手转胎头

[中图分类号] R714 [文献标识码] A [文章编号] 1673-7210（2012）08（a）-0044-02

Analysis of 165 cases about adjustment contraction and hip flexion with manual rotation of fetal head correcting persistent occipitotransverse position or occipitoposterlor position

LIU Xinmei1 LIU Xinling2 DANG Saili1

1.Department of Obstetrics and Gynecology, the Fifth Hospital of Xi'an City, Shaanxi Province, Xi'an 710082, China; 2.Experimental Center, Medical College of Xi'an Jiaotong University, Shaanxi Province, Xi'an 710061, China

[Abstract] Objective To investigate the persistent occipitotransverse position or occipitoposterlor position in adjustment contraction and hip flexion of the clinical effect of manual rotation of fetal head. Methods In our courtyard from March 2010 to February 2012, 165 cases of the clinical data of persistent occipitotransverse position or occipitoposterlor position in adjustment contraction and hip flexion with manual rotation of fetal head were retrospectively analyzed. Results After adjustment contraction and hip flexion with manual rotation of fetal head, 165 maternals of persistent occipitotransverse position or occipitoposterlor position through the vagina after natural childbirth in 126 cases, tires suck midwifery 11 cases, the success rate of 83%; treated as described above invalid, cesarean section 28 cases, accounting for 17%. All newborns had no death, the maternal had no serious complications. Conclusion Persistent occipitotransverse position or occipitoposterlor position in adjustment contraction and hip flexion with manual rotation of fetal head can effectively shorten birth process, reduce maternal pain, on fetal damage, reduce the rate of cesarean section, clinical effect, is worth popularizing.

[Key words] Persistent occipitotransverse position and occipitoposterlor position; Adjustment contraction; Flexion of the hip; Manual rotation of fetal head

据有关报道，目前我国剖宫产率高达46.2%，是世界卫生组织推荐上限的3倍以上[1]。剖宫产率居高不下的原因是产妇怕吃苦，医院怕纠纷，特别是面对持续性枕横位和枕后位等高发性难产时，医院、医生恐处理不当引发医患纠纷，放宽了剖宫产条件。及时、正确诊断和处理持横位和持后位，可以有效地降低手术产率[2-3]。我院在处理持续性枕横位、枕后位时，适时调整宫缩配以屈髋手转胎头位置，有效缩短产程，减少产妇痛苦，使难产转为顺产，降低剖宫产率，现将临床结果报道如下：

1资料与方法