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目的研究不同的干预方式对第三产程结局的影响。方法 300例自然分娩的产妇随机分为三组,每组100例。第一组为对照组,采用自然等待的方法 ,即胎儿娩出后不采取任何干预措施,等待胎盘自然剥离并娩出;第二组在胎儿肩部娩出后给予持续静脉滴注缩宫素20 U加5%葡萄糖注射液500 ml后等待胎盘的剥离及娩出;第三组在胎儿肩部娩出后给予持续静脉滴注缩宫素20 U加5%葡萄糖注射液500 ml,同时在宫底部给予适当力量的按摩子宫直至胎盘娩出。采用容积法和称重法记录三组产妇产时及产后2 h的出血量,并准确记录第三产程的时间。结果第一组与第二组、第三组在产后出血量及第三产程时间差异均有统计学意义(P<0.01);第二组及第三组在第三产程时间上及产后出血量方面差异有统计学意义(P<0.05)。结论对第三产程进行积极按摩子宫并给予缩宫素能够明显缩短第三产程的时间和减少产后2 h的出血量。
Objective To study the impact of different interventions on the outcome of the third stage of labor. Methods 300 cases of spontaneous delivery of women were randomly divided into three groups of 100 cases. The first group as the control group, using a natural wait method, that is, the fetus after delivery without any intervention to wait for natural placental detachment and delivery; the second group after delivery in the fetus sustained intravenous infusion of oxytocin 20 U plus 5% glucose injection 500 ml wait for placental detachment and delivery; the third group given after continuous delivery of fetal shoulder oxytocin 20 U plus 5% glucose injection 500 ml, at the same time give the appropriate power in the bottom of the palace Massage the uterus until the placenta is delivered. Volume and weight method were used to record the amount of bleeding in three groups of maternal and postpartum 2 h, and accurately record the time of the third stage of labor. Results There were significant differences in the amount of postpartum hemorrhage and the third stage of labor among the first group, the second group and the third group (P <0.01); the second group and the third group had significant differences in the time of the third stage of labor and postpartum hemorrhage The difference was statistically significant (P <0.05). Conclusions Active massage of the uterus in the third stage of labor and the administration of oxytocin significantly shorten the time of the third stage of labor and reduce the amount of bleeding at 2 hours postpartum.