瘢痕子宮再次妊娠患者陰道分娩的安全性研究

李少雯

【摘要】 目的 探討瘢痕子宮再次妊娠患者陰道分娩的安全性。方法 57例瘢痕子宮再次妊娠患者， 隨機分為對照組（30例）和觀察組（27例）。對照組采用剖宮產分娩， 觀察組采用陰道試產分娩。比較兩組住院時間、新生兒體質量、出血量、Apgar評分及產褥感染、新生兒窒息、子宮破裂發生情況。結果 兩組新生兒體質量、Apgar評分比較差異無統計學意義（P>0.05）;觀察組出血量（159.5±19.3）ml少于對照組的（278.5±41.6）ml， 住院時間（4.5±1.9）d短于對照組的（7.5±1.3）d， 差異具有統計學意義（P<0.05）。兩組患者均未發生子宮破裂。觀察組產褥感染、新生兒窒息發生率分別為0、3.70%， 均低于對照組的13.33%、23.33%， 差異具有統計學意義（P<0.05）。結論 陰道分娩用于瘢痕子宮再次妊娠患者中具有較高的安全性， 能改善妊娠結局， 值得推廣應用。

【關鍵詞】 瘢痕子宮;陰道分娩;剖宮產分娩;護理

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

瘢痕子宮再次妊娠在臨床上較為常見， 亦是婦產科臨床治療的難點， 且在妊娠、分娩過程中容易引發大出血、子宮破裂等不良情況[1]。剖宮產是瘢痕子宮患者中常用的終止妊娠的方法， 能搶救產婦、新生兒生命， 成為不可經陰道分娩者的重要補救手段。但是， 隨著醫療水平的不斷發展， 人們的分娩觀念發生轉變， 由于剖宮手術對母體損傷相對較大， 術后容易出現各種并發癥， 且剖宮產是子宮瘢痕形成的主要原因。因此， 加強瘢痕子宮再次妊娠患者陰道分娩對改善產婦身心健康具有重要的意義， 但是對該分娩方式的安全性研究較少。因此， 本文以瘢痕子宮再次妊娠患者為對象， 探討瘢痕子宮再次妊娠患者陰道分娩的安全性， 報告如下。