摘要：目的：探讨羊水置换术在治疗产时羊水Ⅱ～Ⅲ°胎粪污染的临床应用。方法：回顾性分析2003年10月至2005年9月在我院分娩时发现产时羊水Ⅱ～Ⅲ°胎粪污染的足月单胎头位分娩孕妇，其中56例行羊水置换术，设为研究组(A组)；随机取未进行羊水置换术的56例作为对照组(B组)，两组一般情况无显著性差异(P>0.05)。观察两组分娩时的羊水的污染度、胎粪吸入综合征、新生儿窒息、新生儿脐血血气分析及剖宫产率等的差异。结果：A组分娩时羊水污染率明显低于B组，两组比较，有显著性差异(X2=31.25，P<0.001)；A组出现胎粪吸入综合征率低于B组，两组比较，具有显著性差异(X2=5.48，P<0.05)；A组新生儿窒息率低于B组，两组比较，具有显著性差异(X2=22.34，P<0.001)； 两组新生儿出生后脐血血气分析的pH、PO2、PCO2、BE值均具显著性差异(t值分别为2.00、5.69、4.38、5.07，P值分别小于0.05、0.01、0.01、0.01)；A组的剖宫产率(44.64%)低于B组 (67.86%)具显著性差异(χ2=5.22，P<0.05)。结论：羊水置换术在产时羊水Ⅱ～Ⅲ°胎粪污染的治疗中有显著的疗效，可以明显改善胎儿宫内羊水污染，纠正胎儿宫内缺氧及胎儿酸中毒有效预防胎粪吸入综合征，减少新生儿窒息及新生儿酸中毒，降低剖宫产率。

     关键词： 羊水置换术； 羊水胎粪污染； 胎粪吸入综合征

    The Clinical Application of Amniotic Fluid Replacement in Ⅱ～Ⅲ° Meconium-stained Amniotic Fluid During Labor

    FENG Xiao-feng, ZHOU Cai-fang, QIU Xiu-li

    (Women and Children Health care Hospital of Gaozhou, Guangdong Gaozhou 525200, China)

    Abstract: Objective: To study the clinical application of amniotic fluid replacement in Ⅱ～Ⅲ° meconium-stained amniotic fluid during labor. Method: We reviewed the single birth with head postion gravidea in term infant in Ⅱ～Ⅲ° meconium-stained amniotic fluid during labor from Oct. 2003 to Sep. 2005. The study group (Agroup) with 56 cases amniotic fluid replacement. The control group (B group) with 56 cases without amniotic fluid replacement. There's no difference between the two groups (P>0.05). Observing the degree of amniotic fluid contamination meconium aspiration syndrome, asphyxia neonatorum. neonate umbilical cord blood blood-gas analysis. Result: The degree of contamination, meconium aspiration syndrome are lower in group A than those in group B. There's significance difference in both group esp PH, PO2.PCO2.BE in neonate umbilical cord blood blood-gas analysis (t=2.00,5.69,4.38,5.07 respectively.P<0.05,0.01,0.01,0.01). The cesarean rate is 44.64% in group A, which is lower than that in group B (67.86%). There's significance difference (X2=5.22,P<0.05). Conclusion: Amniotic fluid replacement in treating Ⅱ～Ⅲ° meconium-stained amniotic fluid during labor which can improve meconium-stained amniotic fluid, intrauterine fetal anoxia and acidose, and preventing meconium aspiration syndrome decrease asphyxia neonatorum and acidose cesarean section rate. ......