Parker Leslie A
College of Nursing, University of Florida, Health Science Center, Gainesville, Fla 32610, USA.
Adv Neonatal Care. 2005 Dec;5(6):288-97; quiz 298-300. doi: 10.1016/j.adnc.2005.09.001.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Sentinel Event Alert from July 21, 2004 states that there have been 47 cases of birth trauma-related perinatal death or permanent disability reported for JCAHO review since 1996. This report clearly illustrates the importance of birth trauma in clinical practice for neonatal and perinatal nurses. Estimates suggest that birth trauma occurs in 2% to 7% of all deliveries and is associated with an increase in both mortality and morbidity. Birth trauma to the head may result in minor superficial extracranial injuries, such as caput succedaneum and cephalohematoma, or more serious and potentially life threatening lesions such as subgaleal hemorrhages. The potential for deeper intracranial injury, such as subarachnoid or subdural hemorrhage exists; these may be isolated or associated with skull fractures and/or other extracranial injuries. Injury to the eye, nasal structures, and paralysis of the vocal cords may also result from birth trauma during a difficulty delivery. Part 1 of this 2-part article will focus on birth injuries to the head and face. Part 2 of the series will review more systemic birth injuries that may involve abdominal organs, the spine and skeletal system, and peripheral and facial nerves.
医疗组织评审联合委员会（JCAHO）2004年7月21日发布的《警示事件警报》指出，自1996年以来，已有47例与分娩创伤相关的围产期死亡或永久性残疾病例上报给JCAHO以供审查。这份报告清楚地说明了分娩创伤在新生儿和围产期护士临床实践中的重要性。据估计，所有分娩中2%至7%会发生分娩创伤，且与死亡率和发病率的增加相关。头部分娩创伤可能导致轻微的浅表性颅外损伤，如头皮水肿和头颅血肿，或更严重且可能危及生命的损伤，如帽状腱膜下出血。存在更严重的颅内损伤可能性，如蛛网膜下腔或硬膜下出血；这些损伤可能是孤立的，也可能与颅骨骨折和/或其他颅外损伤相关。分娩困难时，眼部、鼻结构损伤以及声带麻痹也可能由分娩创伤导致。这篇分两部分的文章的第一部分将聚焦于头部和面部的分娩损伤。该系列文章的第二部分将回顾更多可能涉及腹部器官、脊柱和骨骼系统以及周围神经和面部神经的全身性分娩损伤。
