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  • 當前位置 —論文改論文— 范文

    關于產婦類論文范文素材,與產程中實施體位管理的臨床觀察相關畢業論文格式

    此文是一篇產婦論文范文,關于產婦類論文范文素材,與產程中實施體位管理的臨床觀察相關畢業論文格式。適合不知如何寫產婦及體位及胎兒方面的改論文專業大學碩士和本科畢業論文以及產婦類開題報告范文和職稱論文的作為寫作參考文獻資料下載。

    【關 鍵 詞 】:產程 體位 觀察

    【中圖分類號】R71,R717【文獻標識碼】B【文章編號】1007-8517(2008)4-0019-02

    促進產程進展,預防難產,降低母嬰并發癥是安全分娩的重要保證.頭位難產是難產常見因素之一,其中又以持續性枕后位和枕橫位多見.它可使產婦疲勞、,產程延長、,手術產機會增加,對母兒影響較大.為此,本單位自2006年起對孕婦產時實施體位管理,對200例臨產后枕后位和枕橫位的產婦采取改變體位的方法,減少持續性枕后位和枕橫位的發生,縮短了產程,手術率降低,對提高分娩質量,確保母嬰安全有一定的积极作用.現報告如下:

    產程中實施體位管理的臨床觀察參考屬性評定
    有關論文范文主題研究: 關于產婦的論文范文集 大學生適用: 碩士學位論文、高校大學論文
    相關參考文獻下載數量: 80 寫作解決問題: 寫作資料
    畢業論文開題報告: 論文提綱、論文總結 職稱論文適用: 論文發表、職稱評副高
    所屬大學生專業類別: 寫作資料 論文題目推薦度: 最新題目

    1.資料與方法

    1.研究對象:本單位自2006年1月~2007年10月收集足月單胎妊娠、,臨產后枕后位、,枕橫位、,無明顯頭盆不稱、,健康初產婦200例,隨機分為改變體位組(觀察組)100例和常規體位組(對照組)100例.兩組產婦的年齡、,胎兒的孕周、,胎兒雙頂徑、,股骨長等均無明顯差異.

    1.方法:(1)觀察組:按產程常規处理,產婦精神緊張、,疲乏無力,給予心理疏導,鼓勵產婦增強分娩信心,必要時給予鎮靜、,補液,及时排空膀胱,適時破膜,宮頸水腫者行封閉,宮縮乏力者,靜滴催產素,并以合適飲食.進入活躍期后,宮口開大3~5cm時,經腹部檢查、,肛門檢查或 檢查,發現枕后位、,枕橫位時,產婦取與胎背對側的側俯臥位,即產婦微躬腰部,含胸屈膝,將大腿上收至約于產婦脊柱縱軸成90度角,前胸盡量靠近床面.宮口開全后,宮縮時,囑產婦取半臥屈腿外展式,即雙手抱膝,使髖關節和膝關節高度屈曲,膝部尽可能靠近胸部.觀察記錄產程進展和胎心變化.(2)對照組:產婦按上述產程常規处理,不作體位指導,取自覺舒適的隨意體位,同樣記錄產程進展和胎心變化.

    2.結果

    2.兩組產婦產程平均時間比較:見表1.

    表1顯示,觀察組與對照組第一產程、,第二產程時間有顯著差異,而第三產程兩組體位無變化,差異不顯著,充分表明體位管理可明顯縮短第一、,二產程的時間.

    2.分娩方式:見表2.

    表2顯示,觀察組的產婦自然分娩率高,手術產率低,對照組的產婦自然分娩率低,手術產率高.經統計學处理,兩組差異有顯著性.

    2.3 產后出血,新生兒窒息:見表3.

    表3顯示觀察組的產婦產后出血、,新生兒窒息率低于對照組,兩組比較有顯著差異.

    2.4 新生兒出生體重均值:觀察組為3321.0g,對照組為3295.5g,經統計學处理,兩組胎兒體重差異無顯著性.(P<0.05)

    3.討論

    分娩過程中,胎兒由于受各種力的相互作用,處于相對靜止或转动狀態,懸浮在羊水中的胎兒,受自身體重和羊水浮力的影響,使胎兒沿自身縱軸产生旋轉.凌蘿達認為,胎頭以枕橫位銜接者占大多數,枕后位次之,枕前位最少,胎兒能否以枕前位娩出,胎頭的內旋轉機制十分重要,枕前、,枕橫、,枕后位時胎頭需分別向前旋轉45、,90、,135度.產婦取與胎背對側的側俯臥位,則有助于胎頭沿著最小度數向前旋轉,因為胎兒į

    關于產程中實施體位管理的臨床觀察的畢業論文格式范文
    關于產婦類論文范文素材
    40;重心在背側,臨產初期,胎頭多銜接在骨盆入口平面.枕后位時,胎兒背部重心靠近母體的脊柱,胎兒背部重心接近母體背側.這時取與胎背對側的側俯臥位,可使胎兒背部重心在自身重力、,羊水浮力和產力作用下,胎背向產婦腹部前方转动,帶動胎頭转动,胎兒枕部朝着有利方向旋轉[1]加之側俯臥位時,產婦的腰椎下凹使脊拄與腹壁間給胎兒向前旋轉提供更大的空間,并消除骶岬對子宮的壓迫減少胎體旋轉時的摩檫力,這樣更有利于胎頭的內旋轉.宮口開全后,胎頭多于坐骨棘平面以下,胎兒重力和羊水浮力對胎方位影響減少.而枕后位的胎頭多于棘下1cm、,棘下2cm、,棘下3cm或拔露時仍處于旋轉狀態[2].此时,取半臥雙手抱膝位,使胎兒縱軸與產軸一致,并可使骨盆出口前后徑增大,有利于胎頭下降和俯屈[3].文中結果提示:改變體位組的產程短,手術產率低,產后出血及新生兒窒息不增加.由此可见,臨產后及早發現枕后位和枕橫位,及时改變產婦體位可減少難產,降低手術率,提高 分娩質量.


    怎樣撰寫產婦學位論文
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    參考文獻

    [1]吳霞,范玲,王琪等.兩種體側位法糾正枕后位的臨床觀察[J].中華婦產科雜志,2001,36(8):468-469.

    [2]區煦東,陳小兵,蘇靜等.產程中改變產婦體位矯正胎方位的探討[J].中華婦產科雜志,1997,32(6):529.

    [3]范福香,李素鳳.產婦改變體位在難產中的作用[J].山西醫科大學學報,2000,31(1):256.

    (收稿日期:2008.01.27)

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