CAJ | 학술논문

目的:分析剖宫产从决定手术至胎儿娩出时间(DDI)的影响因素,以及急诊剖宫产DDI对新生儿预后的影响.方法:对472例剖宫产患者根据Lucas分类法分为两组:急诊剖宫产组(291例)与非急诊剖宫产组(181例);急诊剖宫产组中分为DDI≤30分钟组和DDI>30分钟组,分别回顾性分析影响DDI的重要因素、以及DDI对新生儿Apgar评分及脐动脉血气的影响.结果:①急诊剖宫产组的DDI为35.5±11.6分钟,其中210例(72.2%)DDI≤30分钟;非急诊剖宫产组DDI为49.3±22.8分钟,其中86例(47.5%)DDI≤30分钟;②急诊剖宫产组中,与DDI>30分钟相比,DDI≤30分钟可明显改善新生儿脐动脉血pH值以及1分钟Apgar评分(P<0.05);但5分钟Apgar评分比较,两组差异无统计学意义(P>0.05);③DDI>30分钟的主要原因为将孕妇由产房或待产室运送至手术室的耗时(56例,69.1%).结论:并非所有急诊剖宫产手术均能达到DDI≤30分钟的标准,尽量缩短DDI时间有助于最终改善新生儿预后.
목적:분석부궁산종결정수술지태인면출시간(DDI)적영향인소,이급급진부궁산DDI대신생인예후적영향.방법:대472례부궁산환자근거Lucas분류법분위량조:급진부궁산조(291례)여비급진부궁산조(181례);급진부궁산조중분위DDI≤30분종조화DDI>30분종조,분별회고성분석영향DDI적중요인소、이급DDI대신생인Apgar평분급제동맥혈기적영향.결과:①급진부궁산조적DDI위35.5±11.6분종,기중210례(72.2%)DDI≤30분종;비급진부궁산조DDI위49.3±22.8분종,기중86례(47.5%)DDI≤30분종;②급진부궁산조중,여DDI>30분종상비,DDI≤30분종가명현개선신생인제동맥혈pH치이급1분종Apgar평분(P<0.05);단5분종Apgar평분비교,량조차이무통계학의의(P>0.05);③DDI>30분종적주요원인위장잉부유산방혹대산실운송지수술실적모시(56례,69.1%).결론:병비소유급진부궁산수술균능체도DDI≤30분종적표준,진량축단DDI시간유조우최종개선신생인예후.
Objectlve:To assess the influential factors of decision-to-delivery inteval (DDI) in caesarean section, and its influence on neonatal outcomes.Methods:472 caesarean sections were divided into two groups according to Lucas's classification :the emergency caesarean sections as group 1 (291) ; and the e-lective caesarean sections as group 2 (181).It was divided into DDI ≤30 min group and DDI > 30 mir group in group 1.A retrospective study was performed in DDI, influential factors of DDI, neonatal Apgar score and umbilical arterial blood gas.Results: ①The mean DDI was 35.5±11.6 min in group 1,in wgich DDI≤30 min was 210 cases (72.2%) and 49.3 ±22.8 min in group 2, in which DDI≤30 min was 86 cases (47.5%).②IN group 1,umbilical artery pH and Apgar core at 1 min after birth could be improved sigbificantly in the cases of DDI ≤ 30 min (P<0.05) , but no correlation was found between the DDI and Apgar scrore at 5 min ,as compared with DDI ＞30MIN CASES(p＞0.05).③It was mainly influenced by time taken to get the patient into operation room in DDI >30 min (56 cases, 69.1 %).Concluslons :The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as pos-sible might improve the neonatal outcome.