选择性剖宫产与足月儿及近足月儿自发性气胸临床分析

SPONTANEOUS PNEUMOTHORAX IN NEAR-TERM AND TERM NEONATES AFTER SELECTIVE CAESAREAN SECTION

目的探讨新生儿自发性气胸与分娩方式的关系。方法回顾性调查我院2000年1月-2010年3月出生的近足月及足月新生）L52390例，其中剖宫产21256例，（选择性剖宫产10276例，应激性剖宫产或胎膜早破10980例），阴式分娩1134例。37例足月儿及近足月儿新生儿发生自发性气胸。无胎儿宫内急性应激情况的选择性剖宫产24例为A组；有胎儿宫内急性应激或胎膜早破（10例）及自然分娩（3例）的13例为B组。对2组患儿的临床表现及治疗方法进行比较。结果选择性剖宫产新生儿自发性气胸显著高于应激性剖宫产，应激性剖宫产显著高于自然分娩。选择性剖宫产患儿与非选择性剖宫产临床表现及治疗方法无差异。结论足月儿及近足月儿新生儿自发性气胸与分娩方式有关，选择性剖宫产应严格掌握适应症。

To investigate the relationship between spontaneous pneumothorax（SP） in near- term and term neonates and difference delivery. Methods A retrospective study on 52 390 near term and term neonates born in our hospital between Janury 2000 and March 2010,21 256 babies delivered by CS （ 10 276 babies by selective CS and 10 980 babies by emergency CS or CS of rupture of membranes） ,31134 babies delivered by vagina was performed. 37 babies were developed SP. Patients delivered by selective CS were grouped A （n = 24）and patients delivered by emer- gency CS or CS of rupture of membranes （10 cases）and by vagina（3 cases）grouped B （n = 13）. We comparede the two groups patients clinical features and treatment. Results The incidence of of near term and term neonates deliv- ered by selective CS was significant higher than that of neonates delivered by emergency CS or CS of rupture of mem- branes and that of neonates delivered by emergency CS or CS of rupture of membranes significant higher than that of neonats delivered by vagina. There was no difference between group A and group B in the clinical features and treat- ments. Conclusion Spontaneous pneumothorax in near - term and term neonates was relate to the difference delivery. Indications of selective CS should be controlled.