【摘要】 目的探讨使用胎儿中心电子监护系统在产时连续胎心监护中的临床应用。方法对2002年3月至2005年12月在保健院分娩的孕周≥37周的5 660例孕妇(监测组)利用中心电子监护系统进行产时连续胎心监护,同时选择1999年3月至2001年12月在保健院分娩的孕周≥37周,未行中心电子监护系统产时连续胎心监护的4 210例孕妇(对照组)进行比较,分析两组胎儿窘迫发生率、新生儿窒息发生率、死产、新生儿死亡率、剖宫产率和阴道手术产率。结果监测组胎儿窘迫检出率升高为244(4.31%),差异有显著性(2χ=5.653,P<0.05),新生儿窒息发生率显著下降,轻度窒息96(1.70%),2χ=16.142,重度窒息24(0.42%),2χ=18.919,与对照组相比均有显著性差异(P<0.01);两组总的剖宫产率,差异无显著性意义(P>0.05);两组阴道助产手术率差异有显著性(P<0.01)。结论应用中心电子监护系统进行产时连续胎心监护,能及时发现胎儿窘迫,明显降低新生儿窒息率,不增加剖宫产率。更多还原

【Abstract】 Objective To investigate effect of clinical application of central electronic monitoring system(CEMS) for continuous fetal heart monitoring during labor.Methods A total of 5660 pregnant women with≥37 weeks of gestation delivered in our hospital in the period from March,2002 to December,2005(as monitoring group) received central electronic monitoring during labor for continuous fetal heart monitoring.And 4210 pregnant women with same gestational age(as control group)delivered in our hospital in another period from March,1999 to December,2001 were monitored by using intermittent auscultation during labor for fetal heart examination.The rates of fetal distress,neonatal asphyxia,still birth,neonatal death,cesarean section and vaginal operative delivery using forceps or vacuum extractor in the two groups were compared.Results The pregnant women in the monitoring group had a higher fetal distress rate as compared with the control group(P<0.05) but had a significantly lower neonatal asphyxia rate(P<0.01).Of which,96 neonates suffered from mild neonatal asphyxia(1.70%,χ~2=16.142) and 24 neonates suffered from severe neonatal asphyxia(0.42%,(χ~2=18.919)),and there were significant difference between the two groups(both P<0.001).In overall cesarean rate,cesarean rate due to fetal distress,overall use rate of forceps or vacuum extractor during delivery,there were no significant differences between the two groups(all P>0.05),while in vaginal operative delivery rate due to suspected fetal distress,there was significant difference between the two groups(P<0.01).Conclusion Application of central electronic monitoring for continuous fetal heart monitoring doesn’t increase the cesarean section rate but increases vaginal operative delivery rate and decreases the neonatal asphyxia rate.更多还原