自由体位纠正枕后（横）位的效果观察

摘要

Objective:To observe the effect of free posture in correcting posterior occipital(transverse presentation).Method:286 primiparas with posterior occipital(transverse presentation)in our hospital from January 2013 to December 2014 were selected as the research objects.They were divided into the observation group(120 cases)and the control group(166 cases)according to their intentions.The observation group was given position guidance by midwife,they deliveried with free position.The control group lied on the bed with the position of supine or lateral,they were not given position guidance.The success rate of transposition,the rate of vaginal delivery,the cesarean section rate,the situation of drug use and the incidence rate of asphyxia neonatorum were compared between the two groups.Result:The success rate of transposition and the rate of vaginal delivery in the observation group were higher than those in the control group,the cesarean section rate and the usage rate of Oxytocin in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence rate of asphyxia neonatorum in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:Free position in puerpera of the first stage of labor can effectively solve the problems of posterior occipital(transverse presentation), asynclitism and prone flexion bad.It can also promote and support spontaneous delivery,reduce the rate of cesarean section and make labor more individualized,humanity and nature.Hospital in conditional circumstance shall make full use of free position in order to make the labor return to nature.%目的：观察自由体位纠正枕后（横）位的效果。方法：选择2013年1月-2014年12月本院收治的枕后（横）位的初产妇286例作为研究对象，根据产妇意愿分为观察组120例及对照组166例。观察组由助产士进行体位指导，行自由体位；对照组让产妇平卧于产床上，仰卧或侧卧，不行体位指导。比较两组转位成功率、阴道分娩率、剖宫产率、产程中用药及新生儿窒息发生率。结果：观察组转位成功率及阴道分娩率均高于对照组，剖宫产率及缩宫素使用率均低于对照组，比较差异均有统计学意义（P<0.05）；观察组新生儿窒息发生率低于对照组，但比较差异无统计学意义（P>0.05）。结论：产妇于第一产程通过自由变换体位，能有效解决枕后（横）位、头盆倾势不均、俯屈不良等问题，促进和支持了自然分娩，降低了剖宫产率，并使分娩更加个体化、人性化和自然化。医院在有条件情况下应充分利用自由体位，让分娩回归自然。