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标题 瘢痕子宫再次妊娠患者阴道分娩的安全性研究
范文

    李少雯

    

    【摘要】 目的 探讨瘢痕子宫再次妊娠患者阴道分娩的安全性。方法 57例瘢痕子宫再次妊娠患者, 随机分为对照组(30例)和观察组(27例)。对照组采用剖宫产分娩, 观察组采用阴道试产分娩。比较两组住院时间、新生儿体质量、出血量、Apgar评分及产褥感染、新生儿窒息、子宫破裂发生情况。结果 两组新生儿体质量、Apgar评分比较差异无统计学意义(P>0.05);观察组出血量(159.5±19.3)ml少于对照组的(278.5±41.6)ml, 住院时间(4.5±1.9)d短于对照组的(7.5±1.3)d, 差异具有统计学意义(P<0.05)。两组患者均未发生子宫破裂。观察组产褥感染、新生儿窒息发生率分别为0、3.70%, 均低于对照组的13.33%、23.33%, 差异具有统计学意义(P<0.05)。结论 阴道分娩用于瘢痕子宫再次妊娠患者中具有较高的安全性, 能改善妊娠结局, 值得推广应用。

    【关键词】 瘢痕子宫;阴道分娩;剖宫产分娩;护理

    DOI:10.14163/j.cnki.11-5547/r.2020.06.012

    Study on safety of vaginal delivery in second pregnancy patients with scarred uterus? ?LI Shao-wen. Baiyun District Maternal and Child Health Hospital, Guangzhou 510400, China

    【Abstract】 Objective? ?To discuss the safety of vaginal delivery in second pregnancy patients with scarred uterus. Methods? ?A total of 57 cases of second pregnancy patients with scarred uterus were randomly divided into control group (30 cases) and observation group (27 cases). The control group received cesarean delivery, and the observation group received vaginal trial delivery. The hospitalization time, neonatal body mass, amount of hemorrhage, Apgar score and occurrence of puerperal infection, neonatal asphyxia and uterine rupture were compared between the two groups. Results? ?There was no statistically significant difference in neonatal body mass and Apgar score between the two groups (P>0.05). The amount of hemorrhage (159.5±19.3) ml in the observation group was less than (278.5±41.6) ml in the control group, and hospitalization time (4.5±1.9) d was shorter than (7.5±1.3) d in the control group, and the difference was statistically significant (P<0.05). There was no uterine rupture in both groups. The incidence of puerperal infection, neonatal asphyxia were 0 and 3.70% respectively in the observation group, which were lower than 13.33% and 23.33% in the control group, and their difference was statistically significant (P<0.05). Conclusion? ?Vaginal delivery shows high safety in second pregnancy patients with scarred uterus, and it can improve pregnancy outcome. It is worthy of promotion and application.

    【Key words】 Scarred uterus; Vaginal delivery; Cesarean delivery; Nursing

    瘢痕子宫再次妊娠在临床上较为常见, 亦是妇产科临床治疗的难点, 且在妊娠、分娩过程中容易引发大出血、子宫破裂等不良情况[1]。剖宮产是瘢痕子宫患者中常用的终止妊娠的方法, 能抢救产妇、新生儿生命, 成为不可经阴道分娩者的重要补救手段。但是, 随着医疗水平的不断发展, 人们的分娩观念发生转变, 由于剖宫手术对母体损伤相对较大, 术后容易出现各种并发症, 且剖宫产是子宫瘢痕形成的主要原因。因此, 加强瘢痕子宫再次妊娠患者阴道分娩对改善产妇身心健康具有重要的意义, 但是对该分娩方式的安全性研究较少。因此, 本文以瘢痕子宫再次妊娠患者为对象, 探讨瘢痕子宫再次妊娠患者阴道分娩的安全性, 报告如下。

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