中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
13期
113-115
,共3页
瘢痕子宫%再次妊娠%分娩方式%阴道分娩
瘢痕子宮%再次妊娠%分娩方式%陰道分娩
반흔자궁%재차임신%분면방식%음도분면
Cicatricial uterus%Secondary pregnancy%Delivery mode%Vaginal delivery
目的：观察瘢痕子宫再次妊娠选择不同分娩方式的临床情况并分析经阴道分娩的安全性。方法选取2011年7月~2014年12月本院收治的瘢痕子宫再次妊娠产妇225例，其中选择阴道试产分娩产妇107例作为研究组，选择再次剖宫产分娩产妇118例作为对照A组，另选取同期首次妊娠阴道分娩产妇90例作为对照B组，比较3组的临床情况。结果225例再次妊娠产妇中，107例(47.56%)自愿选择且适宜阴道分娩，试产成功71例(66.36%)(观察组)，118例(52.44%)自愿要求或具有剖宫产指征；观察组产妇的的产时、产后出血量明显少于对照A组(剖宫产分娩)，住院时间明显短于对照A组，术后并发症发生率明显低于对照A组(P<0.05)；观察组产妇的产后出血量、产程时间、住院时间、试产成功率及新生儿评分与对照B组差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠产妇选择实施阴道分娩，相比实施剖宫产仍然具有较明显的优势，亦有一定的风险，但实施严格控制阴道试产适应证与禁忌证、加强产时监护等措施能有效提高其安全性与可行性，从而促进临床自然分娩。
目的：觀察瘢痕子宮再次妊娠選擇不同分娩方式的臨床情況併分析經陰道分娩的安全性。方法選取2011年7月~2014年12月本院收治的瘢痕子宮再次妊娠產婦225例，其中選擇陰道試產分娩產婦107例作為研究組，選擇再次剖宮產分娩產婦118例作為對照A組，另選取同期首次妊娠陰道分娩產婦90例作為對照B組，比較3組的臨床情況。結果225例再次妊娠產婦中，107例(47.56%)自願選擇且適宜陰道分娩，試產成功71例(66.36%)(觀察組)，118例(52.44%)自願要求或具有剖宮產指徵；觀察組產婦的的產時、產後齣血量明顯少于對照A組(剖宮產分娩)，住院時間明顯短于對照A組，術後併髮癥髮生率明顯低于對照A組(P<0.05)；觀察組產婦的產後齣血量、產程時間、住院時間、試產成功率及新生兒評分與對照B組差異無統計學意義(P>0.05)。結論瘢痕子宮再次妊娠產婦選擇實施陰道分娩，相比實施剖宮產仍然具有較明顯的優勢，亦有一定的風險，但實施嚴格控製陰道試產適應證與禁忌證、加彊產時鑑護等措施能有效提高其安全性與可行性，從而促進臨床自然分娩。
목적：관찰반흔자궁재차임신선택불동분면방식적림상정황병분석경음도분면적안전성。방법선취2011년7월~2014년12월본원수치적반흔자궁재차임신산부225례，기중선택음도시산분면산부107례작위연구조，선택재차부궁산분면산부118례작위대조A조，령선취동기수차임신음도분면산부90례작위대조B조，비교3조적림상정황。결과225례재차임신산부중，107례(47.56%)자원선택차괄의음도분면，시산성공71례(66.36%)(관찰조)，118례(52.44%)자원요구혹구유부궁산지정；관찰조산부적적산시、산후출혈량명현소우대조A조(부궁산분면)，주원시간명현단우대조A조，술후병발증발생솔명현저우대조A조(P<0.05)；관찰조산부적산후출혈량、산정시간、주원시간、시산성공솔급신생인평분여대조B조차이무통계학의의(P>0.05)。결론반흔자궁재차임신산부선택실시음도분면，상비실시부궁산잉연구유교명현적우세，역유일정적풍험，단실시엄격공제음도시산괄응증여금기증、가강산시감호등조시능유효제고기안전성여가행성，종이촉진림상자연분면。
Objective To observe the clinical conditions of different delivery mode for secondary pregnancy of cicatri-cial uterus and to analyze the safety of vaginal delivery. Methods 225 puerperae with cicatricial uterus for secondary delivery treated in our hospital from July 2011 to December 2014 were selected.among them,107 puerperae selecting vaginal delivery for trial-production were selected as observation group,118 puerperae selecting secondary cesarean section for delivery were selected as control group A,and another 90 puerperae with initial vaginal delivery were select-ed as control group B.Clinical condition of among 3 groups were compared. Results Among 225 puerperae with sec-ondary pregnancy,107 puerperae (47.56%) voluntarily selected and were also appropriate for vaginal delivery and a-mong them,71 cases (66.36%) (observation group) succeeded in delivery.118 puerperae (52.44%) voluntarily requested or had the indication for cesarean section.Bleeding amount during delivery and after delivery in observation group were obviously fewer than those control group A,hospital stay of observation group was obviously shorter than that of control group A,incidence rate of complication after operation in observation group was obviously lower than that of control group A (P<0.05);there was no statistical difference of bleeding amount,labor time,hospital stay,success rate of trial-production and neonatal score between observation group and control group B (P>0.05). Conclusion Vaginal delivery selected by puerpera with cicatricial uterus for secondary delivery still have relatively significantly advantages com-pared with cesarean section,while it also has certain risk,but conducting measures of strictly controlling indications and contraindications of vaginal delivery as well as strengthening monitoring during delivery can effectively improve its safety and feasibility to promote clinical natural delivery.
