孕晚期臀位外倒转术的安全性及影响因素临床分析(1)
【摘要】 目的：探討孕晚期臀位外倒转术的安全性，分析影响手术成功的相关因素，提出相应的措施，以便提高临床手术成功率。方法：本次对象为笔者所在医院2018年4月-2019年11月的53例孕晚期臀位外倒转术孕妇，统计手术成功率，按照外倒转是否成功将孕妇分成成功组和失败组，对手术成功的相关因素进行Logistic单因素、多因素分析。结果：53例孕妇中，外倒转手术成功36例(67.92%)，失败17例(32.08%)，其中，成功组中有3例(8.33%)孕妇选择剖宫产，失败组均使用剖宫产终止妊娠(100%)，两组剖宫产率比较差异有统计学意义(字2=41.29，P<0.05);单因素分析显示，影响孕晚期臀位外倒转术成功的相关因素为孕妇产次、臀位类型、胎盘位置、羊水量、脐带绕颈，同维度指标相比，差异均有统计学意义(P<0.05);Logistic多因素分析显示，初产妇、复合臀位、宫底胎盘位置、羊水量过少、胎儿脐带绕颈为影响孕晚期臀位外倒转术成功的独立危险因素，差异均有统计学意义(P<0.05)。结论：孕晚期臀位外倒转术具有一定的风险性，孕妇产次、臀位类型、胎盘位置、羊水量、脐带绕颈是影响手术成功的主要因素，临床要针对以上因素给予相应的干预措施，提高手术的安全性。
【关键词】 孕晚期 臀位外倒转术 安全性 影响因素
doi：10.14033/j.cnki.cfmr.2020.15.065 文献标识码 B 文章编号 1674-6805(2020)15-0-03
The Clinical Analysis of the Safety and the Influence Factors of the External Cephalic Version in the Late Stage of Pregnancy/WANG Miaona， JIN Xiqiang， LI Xiaoxia， LIU Xiaoping， ZHUO Haiwen. //Chinese and Foreign Medical Research， 2020， 18(15)： -156
[Abstract] Objective： To explore the safety of external cephalic version in the late stage of pregnancy， analyze the related factors affecting the success of the operation， and put forward the corresponding measures in order to improve the success rate of clinical surgery. Method： From April 2018 to November 2019， 53 pregnant women with advanced breech inversion were enrolled in this study. According to the success rate of operation， the pregnant women were divided into the successful group and the failure group according to whether the external inversion was successful， and the related factors of operation success were analyzed by Logistic single factor and multi factor. Result： Of the 53 pregnant women， 36 cases (67.92%) were successful， 17 cases (32.08%) had failed， among them， 3 cases (8.33%) in the successful group chose cesarean section， and the failure group all used cesarean section to terminate pregnancy (100%)， there was statistically significant difference in the cesarean section rate between the two groups (字2=41.29， P<0.05). The single factor analysis showed that the relative factors influencing the success of the operation were the birth order， the type of hip position， the position of placenta， the amount of sheep water， the umbilical cord around the neck， compared to the same dimension， the differences were statistically significant (P<0.05). Logistic multivariate analysis showed that primipara， compound gluteal position， placenta position of uterine floor， too little amount of amniotic fluid， and fetal umbilical cord around the neck were independent risk factors for the success of breech transposition in the third trimester of pregnancy， the differences were statistically significant (P<0.05). Conclusion： In the late stage of pregnancy， external cephalic version has a certain risk. The main factors affecting the success of the operation are the delivery of pregnant women， the type of breech presentation， the position of placenta， amniotic fluid and umbilical cord around the neck. The corresponding intervention measures should be given to improve the safety of the operation., 百拇医药(王妙娜 金细强 李小霞 刘小平 卓海文)
【关键词】 孕晚期 臀位外倒转术 安全性 影响因素
doi：10.14033/j.cnki.cfmr.2020.15.065 文献标识码 B 文章编号 1674-6805(2020)15-0-03
The Clinical Analysis of the Safety and the Influence Factors of the External Cephalic Version in the Late Stage of Pregnancy/WANG Miaona， JIN Xiqiang， LI Xiaoxia， LIU Xiaoping， ZHUO Haiwen. //Chinese and Foreign Medical Research， 2020， 18(15)： -156
[Abstract] Objective： To explore the safety of external cephalic version in the late stage of pregnancy， analyze the related factors affecting the success of the operation， and put forward the corresponding measures in order to improve the success rate of clinical surgery. Method： From April 2018 to November 2019， 53 pregnant women with advanced breech inversion were enrolled in this study. According to the success rate of operation， the pregnant women were divided into the successful group and the failure group according to whether the external inversion was successful， and the related factors of operation success were analyzed by Logistic single factor and multi factor. Result： Of the 53 pregnant women， 36 cases (67.92%) were successful， 17 cases (32.08%) had failed， among them， 3 cases (8.33%) in the successful group chose cesarean section， and the failure group all used cesarean section to terminate pregnancy (100%)， there was statistically significant difference in the cesarean section rate between the two groups (字2=41.29， P<0.05). The single factor analysis showed that the relative factors influencing the success of the operation were the birth order， the type of hip position， the position of placenta， the amount of sheep water， the umbilical cord around the neck， compared to the same dimension， the differences were statistically significant (P<0.05). Logistic multivariate analysis showed that primipara， compound gluteal position， placenta position of uterine floor， too little amount of amniotic fluid， and fetal umbilical cord around the neck were independent risk factors for the success of breech transposition in the third trimester of pregnancy， the differences were statistically significant (P<0.05). Conclusion： In the late stage of pregnancy， external cephalic version has a certain risk. The main factors affecting the success of the operation are the delivery of pregnant women， the type of breech presentation， the position of placenta， amniotic fluid and umbilical cord around the neck. The corresponding intervention measures should be given to improve the safety of the operation., 百拇医药(王妙娜 金细强 李小霞 刘小平 卓海文)