中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2008年
4期
218-221
,共4页
刘娜%边旭明%马良坤%滕莉荣%戚红%龚晓明%刘俊涛%杨剑秋
劉娜%邊旭明%馬良坤%滕莉榮%慼紅%龔曉明%劉俊濤%楊劍鞦
류나%변욱명%마량곤%등리영%척홍%공효명%류준도%양검추
剖宫产术,再%妊娠结局%粘连%子宫破裂
剖宮產術,再%妊娠結跼%粘連%子宮破裂
부궁산술,재%임신결국%점련%자궁파렬
Cesarean section,repeat%Pregnancy outcome%Adhesions%Uterine rupture
目的 探讨重复剖宫产对孕产妇及围产儿结局的影响.方法 回顾性分析1998年1月1日至2007年12月31日,在北京协和医院妊娠超过28周行再(多)次剖宫产手术分娩的产妇共412例,根据剖官产次数分为再次剖宫产组(repeated caesarean section group,RCS组,394例)和多次剖宫产组(multiple caesarean section group,MCS组,18例),随机选取同期行初次剖宫产手术分娩的480例为初次剖宫产组(first caesarean section group,FCS组)作为对照,分析三组孕妇的一般临床资料、产时产后并发症及围产儿结局.结果 近十年我院再次剖官产率为4.1%,呈逐年上升趋势.(1)一般临床资料比较:RCS组及MCS组平均年龄分别为(33.7±4.3)岁,(34.5±5.1)岁,大于FCS组(31.5±4.3)岁(P<0.05).RCS组及MCS组平均孕次分别为(3.5±1.4)次,(4.7±1.5)次,多于FCS组(2.1±1.2)次(P<0.05).(2)盆腔粘连发生率:RCS组及MCS组分别为13.5%和50.0%,高于FCS组(0.4%)(P<0.05).(3)子宫破裂发生率:RCS组(1%)高于FCS组(0%)(P<0.05).(4)RCS组及MCS组平均分娩孕周分别为(38.1±1.8)周,(37.3±2.5)周,与FCS组[(38.9±2.1)周]比较差异有统计学意义(P<0.05).结论 再 (多)次剖宫产发生率逐年上升,其显著增加盆腔粘连及子官破裂的发生率,但并不增加围产儿并发症的发生率.
目的 探討重複剖宮產對孕產婦及圍產兒結跼的影響.方法 迴顧性分析1998年1月1日至2007年12月31日,在北京協和醫院妊娠超過28週行再(多)次剖宮產手術分娩的產婦共412例,根據剖官產次數分為再次剖宮產組(repeated caesarean section group,RCS組,394例)和多次剖宮產組(multiple caesarean section group,MCS組,18例),隨機選取同期行初次剖宮產手術分娩的480例為初次剖宮產組(first caesarean section group,FCS組)作為對照,分析三組孕婦的一般臨床資料、產時產後併髮癥及圍產兒結跼.結果 近十年我院再次剖官產率為4.1%,呈逐年上升趨勢.(1)一般臨床資料比較:RCS組及MCS組平均年齡分彆為(33.7±4.3)歲,(34.5±5.1)歲,大于FCS組(31.5±4.3)歲(P<0.05).RCS組及MCS組平均孕次分彆為(3.5±1.4)次,(4.7±1.5)次,多于FCS組(2.1±1.2)次(P<0.05).(2)盆腔粘連髮生率:RCS組及MCS組分彆為13.5%和50.0%,高于FCS組(0.4%)(P<0.05).(3)子宮破裂髮生率:RCS組(1%)高于FCS組(0%)(P<0.05).(4)RCS組及MCS組平均分娩孕週分彆為(38.1±1.8)週,(37.3±2.5)週,與FCS組[(38.9±2.1)週]比較差異有統計學意義(P<0.05).結論 再 (多)次剖宮產髮生率逐年上升,其顯著增加盆腔粘連及子官破裂的髮生率,但併不增加圍產兒併髮癥的髮生率.
목적 탐토중복부궁산대잉산부급위산인결국적영향.방법 회고성분석1998년1월1일지2007년12월31일,재북경협화의원임신초과28주행재(다)차부궁산수술분면적산부공412례,근거부관산차수분위재차부궁산조(repeated caesarean section group,RCS조,394례)화다차부궁산조(multiple caesarean section group,MCS조,18례),수궤선취동기행초차부궁산수술분면적480례위초차부궁산조(first caesarean section group,FCS조)작위대조,분석삼조잉부적일반림상자료、산시산후병발증급위산인결국.결과 근십년아원재차부관산솔위4.1%,정축년상승추세.(1)일반림상자료비교:RCS조급MCS조평균년령분별위(33.7±4.3)세,(34.5±5.1)세,대우FCS조(31.5±4.3)세(P<0.05).RCS조급MCS조평균잉차분별위(3.5±1.4)차,(4.7±1.5)차,다우FCS조(2.1±1.2)차(P<0.05).(2)분강점련발생솔:RCS조급MCS조분별위13.5%화50.0%,고우FCS조(0.4%)(P<0.05).(3)자궁파렬발생솔:RCS조(1%)고우FCS조(0%)(P<0.05).(4)RCS조급MCS조평균분면잉주분별위(38.1±1.8)주,(37.3±2.5)주,여FCS조[(38.9±2.1)주]비교차이유통계학의의(P<0.05).결론 재 (다)차부궁산발생솔축년상승,기현저증가분강점련급자관파렬적발생솔,단병불증가위산인병발증적발생솔.
Objective To investigate the effects of repeated caesarean section (RCS) on maternal and neonatal outcomes. Methods From January 1998 to December 2007, 412 cases underwent RCS at Peking Union Medical College Hospital were reviewed and divided into two groups based on the number of CSs: RCS group (n= 394) and multiple caesarean section (CS) group (MCS group, n= 18). General conditions, maternal complications and neonatal outcomes were compared among RCS group, MCS group and first CS groups (FCS group) which consisted of 480 women underwent the first CS during the same period. Results The incidence of RCS was 4. 0% with an increasing trend during the past ten years. (1) The mean age of RCS and MCS group were (33.7± 4. 3) yrs and (34. 5±5.1)yrs respectively, higher than FCS group (P<0. 05). The average gravidity in RCS and MCS group were (3.5±1.4), (4. 7±1.5) respectively, higher than FCS group (2.1± 1.2, P<0. 05). (2) The rate of severe pelvic adhesion and uterus rupture were significantly higher in RCS group than in FCS group (13.5% vs 0. 4%, 1% vs 0%, P<0. 05). (3) The mean gestations of RCS group and MCS group were (38.1±1.8)weeks and (37.3±2.5)weeks respectively, while it was (38. 9±2. 1) weeks in the FCS group (P<0. 05). Conclusions RCS rate is growing. Although RCS would increase the incidence of dense adhesion and uterine rupture, it is a relatively safe procedure without increasing the neonatal morbidity.
