摘要
目的探讨慢性乙型肝炎经阴道分娩产妇在第二产程中实施侧卧位并配合自主用力的分娩方式,对乙肝母婴传播率和分娩结局的影响。方法选取2018年2—9月在首都医科大学附属北京佑安医院经阴道分娩的200例慢性乙型肝炎初产妇,按随机数字表法随机分为观察组和对照组,每组100例。观察组在第二产程中选择侧卧位并自主用力,对照组采用常规的膀胱截石位,比较两组分娩结局和HBV母婴传播率。结果观察组第二产程时间(41.91±22.43)min,产时出血量(135.00±62.16)ml,均低于对照组,差异有统计学意义(t值分别为2.057、2.234;P<0.05)。观察组会阴侧切10例,低于对照组;自然裂伤90例,高于对照组,差异均有统计学意义(P<0.05);观察组无手术助产及新生儿窒息情况,对照组分别为3例和2例,但差异无统计学意义(P>0.05)。两组新生儿出生时检测HBsAg阳性检出者,观察组为12例,对照组为18例,差异无统计学意义(P>0.05);两组新生儿7月龄时检测,均无HBsAg阳性检出者。结论乙肝病毒携带产妇在第二产程中采用侧卧位并配合自主用力的分娩方式,不会增加乙肝母婴传播风险,能够有效缩短第二产程的时间、减少会阴部的损伤及产时出血量、降低新生儿产时暴露的机会,母婴结局良好。
Objective To explore the effects of lateral position and autonomous exertion autonomous delivery during the second stage of labor on hepatitis B virus(HBV)mother-baby transmission and delivery outcome in vaginal delivery maternal with chronic hepatitis B.Methods From February to September 2018,this study selected 200 chronic hepatitis B primiparas delivered vaginally at Beijing Youan Hospital of Capital Medical University.All of primiparas were randomly divided into observation group and control group by random number table,100 cases in each group.Observation group carried out lateral position and autonomous exertion during the second stage of labor,while control group adopted the routine lithotomy position.The delivery outcome and incidence of HBV mother-baby transmission were compared between two groups.Results In observation group,the time of the second stage of labor and blood loss during labor were(41.91±22.43)min and(135.00±62.16)ml respectively lower than those in control group with statistical differences(t=2.057,2.234;P<0.05).There were 10 cases with episiotomy in observation group less than that in control group;and 90 cases with natural laceration in observation group more than that in control group with statistical differences(P<0.05).There were no cases with surgical delivery and neonatal asphyxia in observation group,but 3 cases with surgical delivery and 2 cases with neonatal asphyxia in control group with no statistical differences(P>0.05).There were 12 newborn infants with HBsAg positive at birth in observation group and 18 in control group with no statistical difference(P>0.05).There were no baby of 7 months old with HBsAg positive between two groups.Conclusions Among chronic hepatitis B parturients,lateral position and autonomous exertion autonomous delivery during the second stage of labor does not increase the risk of HBV mother-baby transmission,and can effectively shorten the time of the second stage of labor,decrease the perineum injury,blood loss during labor and exposure opportunity of
作者
吕婧
张利
李秋云
张华
Lyu Jing;Zhang Li;Li Qiuyun;Zhang Hua(Women and Children Centre,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)
出处
《中华现代护理杂志》
2020年第5期644-647,共4页
Chinese Journal of Modern Nursing
基金
北京市科技计划传染病重大专项研究(D161100002716004)
"十三五"国家科技重大专项研究(2017ZX10201201-001-009)。
关键词
肝炎
乙型
慢性
产程
第二
侧卧位
自主用力
母婴传播
Hepatitis B
chronic
Labor stage
second
Lateral position
Autonomous exertion
Mother-baby transmission
