瘢痕子宮陰道分娩進行產程管理的效果觀察

王飛燕

[摘要] 目的 觀察瘢痕子宮陰道分娩進行產程管理的效果。 方法 選取2016年3～10月我院60例瘢痕子宮陰道分娩產婦作為觀察對象，采用隨機數字表法分為干預組和對照組，每組各30例，對照組行常規管理，干預組進行科學有效的產程管理，對比兩組產婦分娩前后的HAMA評分，及其他各項臨床觀察指標包括第一產程、第二產程所用時間、產后出血情況及新生兒窒息發生率。 結果 干預組與對照組產婦分娩前HAMA評分比較，差異不顯著（P>0.05）。分娩后，干預組和對照組產婦的HAMA評分分別較干預前顯著降低，且干預組產婦的HAMA評分顯著低于對照組，組間比較，差異具有顯著性（P<0.05）。干預組的第一產程、第二產程所用時間明顯短于對照組，干預組產婦的產后出血量明顯少于對照組，產后出血率及新生兒窒息發生率也顯著低于對照組，組間比較，差異具有顯著性（P<0.05）。 結論 瘢痕子宮陰道分娩進行產程管理有利于縮短產程時間，減少產后出血量，降低新生兒窒息的發生率，提高分娩質量。

[關鍵詞] 瘢痕子宮；陰道分娩；產程管理；產后出血

[中圖分類號] R473.71；R719.8 [文獻標識碼] B [文章編號] 1673-9701（2017）12-0113-03

[Abstract] Objective To observe the effect of labor management for scar uterus vaginal delivery. Methods 60 puerperas with scar uterus vaginal delivery in our hospital from March to October in 2016 were chosen and randomly divided into intervention group（n=30） and control group（n=30）. The control group was treated with routine management and the intervention group was given scientific and effective labor management. The maternal HAMA score before and after delivery， as well as other clinical indicators including the first stage of labor， the second time of labor， postpartum hemorrhage and neonatal asphyxia between the two groups was compared. Results There was no significant difference in the scores of HAMA between the intervention group and the control group before delivery（P>0.05）. After delivery， the HAMA scores of the intervention group and the control group were significantly lower than those before the intervention.The HAMA score of the intervention group was significantly lower than that of the control group， and there was significant difference between the two groups（P<0.05）. The time of the first stage and the second stage of labor in the intervention group was significantly shorter than that of the control group.The postpartum hemorrhage volume， postpartum hemorrhage rate and neonatal asphyxia rate in the intervention group were significantly lower than those of the control group， and the difference was significant between the two groups（P<0.05）. Conclusion The labor management for scar uterine vaginal delivery is helpful to shorten the time of labor， reduce the amount of postpartum hemorrhage and incidence of neonatal asphyxia， and improve the quality of childbirth.

[Key words] Scar uterus； Vaginal delivery； Labor management； Postpartum hemorrhage

瘢痕子宮產婦因有子宮手術史，其妊娠具有較大的風險，若在產婦分娩的產程中未進行科學、合理的管理，產婦在分娩過程中易發生子宮破裂、大出血或新生兒窒息等嚴重后果[1]。本研究對瘢痕子宮陰道分娩產婦在分娩的產程過程中進行密切觀察及有效管理，取得了較好的效果，現報道如下。

1 對象與方法

1.1研究對象

選取2016年3～10月我院60例瘢痕子宮陰道分娩產婦作為觀察對象，身體健康，無先兆子宮破裂、頭盆不稱和其他嚴重內科并發癥；各項指標均符合陰道分娩指征，且同意并選擇陰道試產。其中產婦年齡最小的為22歲，最大的產婦年齡為42歲，平均年齡（35.3±11.6）歲。將入選的60例產婦采用隨機數字表法分為干預組和對照組，每組各30例，兩組的年齡、平均孕周及再次妊娠距首次妊娠間隔等臨床資料組間對比顯示，差異不顯著（P>0.05），具有可比性。兩……