人工破膜联合地西泮应用于活跃期停滞临床观察.docVIP

人工破膜联合地西泮应用于活跃期停滞临床观察 　　doi：10.3969/j.issn.1007-614x.2014.1.25 　　摘 要 目的：了解人工破膜联合地西泮应用于活跃期停滞的临床效果。方法：随机选择在潮州市妇幼保健院分娩，进入产程的足月、单胎妊娠、头先露、活跃期时限出现异常（包括活跃期停滞和活跃期延长）的367例初产妇病历资料，回顾性分析活跃期停滞期间应用人工破膜联合地西泮对阴道分娩和剖宫产分娩者妊娠结局的影响。结果：367例活跃期停滞者中，剖宫产182例，阴道分娩185例。两组产后出血发生率、产妇并发症率差异均无统计学意义（P0.05），两组活跃期≥6小时者新生儿转儿科率高于活跃期6小时组（P0.05）。结论：宫口扩张6cm以下出现活跃期异常者，母儿情况良好，可人工破膜联合应用地西泮静推，适当延长产程观察时限。 　　关键词 分娩过程 活跃期停滞 人工破膜 地西泮 剖宫产术 　　Abstract Objective：To observe the clinical effect of artificial amniorrhexis combined with diazepam used in active phase stagnation.Methods：To collect 367 cases of primipara medical records From 2009 May to 2013 February delivery，into labor full-term，singleton pregnancy，cephalic presentation，active period of abnormal（including the active period of stagnation and prolonged active phase）.A retrospective analysis of the effect of artificial rupture of membrane combined with diazepam on vaginal delivery and cesarean section pregnancy outcomethe during active period of stagnation.Results：In the 367 cases of active period of stagnation，182 patients used cesarean section and 185 cases used vaginal delivery.The incidence of postpartum hemorrhage and the rate of maternal complications in the 2 groups were not statistically significant（P0.05）.Neonatal transfer pediatric rate of active period over 6 hours in the 2 groups is higher than the active period of less than 6 hours（P0.05）.Conclusion：If mother in good condition with dilatation of cervix below 6cm appear abnormal active stage，she can be treated with artificial amniorrhexis combined with diazepam.We should be appropriate to extend the duration time of observation. 　　Key words The birth process；Active phase stagnation；Artificial amniorrhexis；Diazepam；Cesarean section 　　自从1955年Friedman制定产程曲线图以来，国内一直沿用至今。然而，经历了50多年，初产妇的平均年龄、妊娠前体重指数和妊娠期体重增长以及新生儿的平均出生体重都较以前有所不同，按照以前的标准处理产程对母儿有无影响，国内相关研究不多[1]。活跃期作为产程进展过程中的一个时段，指宫口开大3～10cm的一段时间。活跃期异常包括活跃期停滞和活跃期延长，在临床都比较常见，处理不当会增加剖宫产和母婴并发症的发生风险。因此，本研究旨在了解活跃期时限的处理对分娩方式以及妊娠结局的影响。 　　资料与方法 　　200