98例头位难产的治疗体会

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1、98例头位难产的治疗体会作者：梅梅单位：巴中市人民医院,四川巴中【摘要】目的：总结98例头位难产的治疗体会。方法：对我院2002年1月至2004年12月收治98例头位难产患者的临床资料进行回顾性分析，其中骨盆狭窄28例(入口平面狭窄14例，中骨盆平面狭窄9例，出口平面狭窄5例)；胎头双顶径≥9.6cm、胎儿体重4000g以上13例，胎头位置异常13例(额位2例、前不均倾2例、持续性枕横位4例、枕后位3例、高直位1例、面先露1例)，原发性宫缩乏力9例，继发性宫缩乏力35例。结果：剖宫产64例，胎吸助产12例，徒手转胎头3例，经阴道自然分娩19例。64例剖宫产中，58例

2、为子宫下段切口，6例为子宫体切口。术中出血大于400ml以上10例，术后24h内出血大于400ml4例。阴道助产12例中，会阴切口延伸撕裂Ⅱ°4例，会阴撕裂Ⅲ°并尿道口及左小阴唇撕裂1例，会阴大血肿2例。无一例产妇死亡。结论：及时发现和识别头位难产是治疗的前提，头位难产不易识别，常使医务人员麻痹大意，只有严密观察产程，做好产程曲线图才能及时发现，正确地处理。【关键词】头位难产胎儿分娩　TheExperienceofTreatmentabout98CasesHeadDifficultLabors　　MEIMei　　(BazhongPeople'sHospit

3、al,Bazhong,Sichuan636000,China)　　Abstract:ObjectiveSummarizetheexperienceof98casesdifficultlybearingcases.MethodsAnalysistheclinicalmaterialsofthe98casesdifficultlaborsbetweenJanuary,2002toDecember,2004.Amongthemare28caseswhosepelvisesarenarrow(theentranceplane14,themiddlepelvisesplane9,t

4、heexitplane5).Thereare13casesinwhichtheheadofthefoetusisbeyond9.6cmandtheweightofthefoetusisbeyond4000g.Theunusualheadpositionsofthefoetusare13cases.Thereare9casesinwhichthepatient'swomboriginallyshrinksoftlywhile35casesinwhichthepatient'swomlcontinuetoshrinksoftly.ResultsCaesareanbirth64

5、cases,birthunderthehelpofaspirator12cases,changingthepositionoftheheadoffoetusbyhand3cases,naturalbirththroughvagina19cases.Amongthe64Caesareanbirths,thereare58casesincisiononthebottomofthewomb,6casesincicionthewomb.There10casesinwhichthenumberofbleedingisbeyond400mlduringtheoperationandt

6、hereare14casesinwhichthenumberofbleedingisbeyond400mlwithin24hoursafteroperation.Amongthe12casesunderthehelpthesapiratorthroughvagina,perineumcutspreadinglacerationⅡ°4cases,perineumlacerationⅢ°andtheentranceoftheurethraandleftsmall1case,andperineumheavyhematoma2cases.Nopuerperantd

7、ies.ConclusionIt'sthepremisetotimelyfindandrecognizetheheadoffoetusinthewrongposition.Butit'sdifficulttorecognizeandoftenmakesmedicalpersonnelbeofftheirguard.Onlybyobservingcarefullytheprocessofbirthandmakingthechartoftheprocessofbirthcanwefindtheproblemtimelyanddea