[1]李　瓅,张冬梅,尤小燕,等.臀位外倒转手术效果影响因素分析[J].新乡医学院学报,2020,37(7):630-632.[doi:10.7683/xxyxyxb.2020.07.007]
　LI Li,ZHANG Dongmei,YOU Xiaoyan,et al.Analysis of the factors influencing the effect of external cephalic version[J].Journal of Xinxiang Medical University,2020,37(7):630-632.[doi:10.7683/xxyxyxb.2020.07.007]
点击复制

臀位外倒转手术效果影响因素分析
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年7
页码:
630-632
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Analysis of the factors influencing the effect of external cephalic version
作者:
李　瓅; 张冬梅; 尤小燕; 周亚丹; 郭 静; 王雅莉
（郑州大学附属郑州中心医院妇产科，河南　郑州　450007）
Author(s):
LI Li; ZHANG Dongmei; YOU Xiaoyan; ZHOU Yadan; GUO Jing; WANG Yali
(Department of Obstetrics and Gynecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan Province,China)
关键词:
臀位; 外倒转术; 剖宫产
Keywords:
presentation; external cephalic inversion; cesarean section
分类号:
R714.44
DOI:
10.7683/xxyxyxb.2020.07.007
文献标志码:
A
摘要:
目的　探讨影响足月臀位外倒转手术成功相关因素。方法　回顾性分析2017年8月至2019年9月于郑州大学附属郑州中心医院实施臀位外倒转术的126例孕晚期单胎孕妇的临床资料，按外倒转手术结果分为成功组（n=75）和失败组（n=51），分析影响外倒转手术结果的相关因素，并比较2组孕妇分娩方式和并发症发生情况。结果　126例患者中，外倒转手术成功75例，总体成功率为59.5%（75/126），失败51例，总体失败率为40.4%（51/126）；其中初产妇成功率为46.3%（31/67），经产妇成功率为74.5%（44/59）。2组孕妇的年龄、操作孕周、体质量指数、胎盘位置比较差异无统计学意义（P>0.05）；2组孕妇的产次、羊水指数、胎先露类型比较差异有统计学意义（P<0.05）。75例外倒转成功孕妇中，73例自然分娩,2例后续行剖宫产；51例外倒转失败孕妇均行剖宫产。成功组1例发生新生儿窒息，2组均无胎膜早破发生。结论　单胎臀位孕妇足月后行外倒转可以提高自然分娩成功率，术前应充分评估孕妇情况，重点关注产次、羊水指数、胎先露类型等因素。
Abstract:
Objective　To investigate the factors influencing the results of external cephalic version (ECV) of full-term breech position gravida.Methods　The clinical data of 126 full-term breech position pregnant women who received ECV in Zhengzhou Central Hospital Affiliated to Zhengzhou University from August 2017 to September 2019 were analyzed retrospectively.They were divided into success group(n=75) and failure group(n=51) according to the results of ECV.The related factors influencing the results of ECV were analyzed.The delivery mode and complications were compared between the two groups.Results　Among the 126 pregnant women,75 were successful after the operation,the overall success rate was 59.5% (75/126),51 were failed and the overall failure rate was 40.4% (51/126).The success rate of primipara was 46.3% (31/67),and the success rate of multipara was 74.5% (44/59).There was no significant difference in the age,gestational age,body mass index and placental position between the two groups（P>0.05）;while there was significant difference in the parity,amniotic fluid index and fetal presentation type between the two groups（P<0.05）.In the success group,73 pregnant women were spontaneous delivery,2 pregnant women were uterine-incision delivery;in the failure group,all pregnant women were given uterine-incision delivery.One case of neonatal asphyxia occurred in the success group,and there was no premature rupture of membrane in the two groups.Conclusion　The success rate of natural delivery can be improved by ECV in full-term breech position pregnancy women.The conditions of pregnancy women should be fully evaluated before operation and the evaluation should focus on parity,amniotic fluid index and fetal presentation type,etc.

参考文献/References:

［1］　谢幸,苟文丽.妇产科学［M］.北京:人民卫生出版社,2014:202-205.
［2］　KIM G J.Reviving external cephalic version:a review of its efficacy,safety,and technical aspects［J］.Obstet Gynecol Sci,2019,62(6):371-381.
［3］　郝秀兰,白小艺,梅志雄,等.孕晚期臀位外倒转术的安全性和影响因素的临床分析［J］.中山大学学报(医学版),2018,39(3):443-447.
［4］　马翠,伍绍文,刘晓巍.足月臀位外倒转术成功的相关因素分析［J］.实用妇产科杂志,2019,35（6）:445-449.
［5］　COLLINS S，ELLAWAY P，HARRINGTON D，et al．The complications of external cephalic version:results from 805 consecutive attempts［J］．BJOG，2007，4(5)：636-638．
［6］　TONG L V,SUEN S S,SINGH S D,et al.External cephalic version does not increase the risk of intrauterine death:a 17-year expe-rience and literature review［J］.J Matern Fetal Neonatal Med,2012,25 (9):1774-1778.
［7］　HOFMEYR G J,KULIER R.External cephalic version for breech presentation at term ［J/CD］.Cochrane Database Syst Rev,2012,10:CD000083.
［8］　王晓怡,柯彩萍.再谈臀位外倒转术［J］.中华产科急救电子杂志,2018,7(3):148-152.DOI:10.3877/cma.j.issn.2095-3259.2018.03.006.
［9］　KOK M,CNOSSEN J,GRAVENDEEL L,et al.Ultrasound factors to predict the outcome of external cephalic version:a meta-analysis ［J］.Ultrasound Obstet Gynecol,2009,33(1):76-84.
［10］　李洁,孙凤英,赵霞,等.臀位外倒转术的成功率及其影响因素［J］.中华围产医学杂志,2014,17(3):169-172.
［11］　FERREIRA J C,BOROWSKI D,CZUBA B,et al.The evolution of fetal presentation during pregnancy:a retrospective,descriptive cross-sectional study［J］.Acta Obstet Gynecol Scand,2015,94(6):660-663.
［12］　尹爱兰,胡海燕,钟梅.美国妇产科医师学会臀位外倒转指南(2016)解读［J］.妇产与遗传:电子版,2016,6(4):26-30.DOI:10.3868/j.issn.2095-1558.2016.04.007.
［13］　GOETZINGER K R,HARPER L M,TUULI M G,et al.Effect of regional anesthesia on the success rate of external cephalic version:a systematic review and meta-analysis［J］.Obstet Gynecol,2011,118(5):1137-1144.

相似文献/References:

[1]梁武凤,骆亚平,姜彩霞,等.臀位改良式膝胸卧位转胎114例分析[J].新乡医学院学报,1997,14(01):067.

更新日期/Last Update: 2020-07-05