两种手术用于足月妊娠临产胎儿窘迫对母婴结局的影响

Influence of two kinds of delivery operation on maternal and neonatal outcomes in full term pregnancy with fetal distress

目的比较剖宫产与阴道助产在足月妊娠临产胎儿窘迫中对母婴结局的影响。方法对2011年1月至2013年12月该院妇产科收治的120例足月妊娠临产胎儿窘迫的患者资料进行回顾性分析,依据所采用手术方式的不同分为剖宫产组和阴道助产组,并比较两种方法在足月妊娠临产胎儿窘迫中对母婴结局的影响。结果剖宫产组手术时间（35.62±6.64）min、出血量（410.45±90.40）mL,显著低于阴道助产组的（67.41±7.00）min、（702.23±110.46）mL,差异有统计学意义（t=23.90、14.46,P〈0.05）。剖宫产组和阴道助产组均无子宫内膜炎、切口感染、产褥病和子宫切除等并发症。剖宫产组：0～≤3分0例,〉7分52例;阴道助产组：0～3分2例,〉7分23例,两组比较差异有统计学意义（χ2=2.34、2.21,P〈0.05）。剖宫产组新生儿窒息率35.00%（28/80）,阴道助产组新生儿窒息率42.50%,两组比较差异无统计学意义（χ2=0.948,P〉0.05）。剖宫产组新生儿并发症发生率6.25%,病死率1.25%,阴道助产组新生儿并发症发生率22.50%,病死率7.50%,两组比较差异有统计学意义（χ2=9.308、4.237,P〈0.05）。结论剖宫产术在治疗足月妊娠临产胎儿窘迫中临床效果好,并发症少,可以使产妇和新生儿有良好的结局,提高母婴生活质量,值得推广应用。

Objective To compare the cesarean section and vaginal delivery at term pregnancy ,fetal distress in labor impact on maternal and neonatal outcomes .Methods The hospital in June 2012 to December 2013 Obstetrics and Gynecology term pregnancy treated 120 cases of fetal distress in labor cases were retrospectively analyzed accord‐ing to different surgical methods used are divided into two groups：cesarean production group and vaginal delivery group ,comparing the two methods in term pregnancy with fetal distress in labor impact on maternal and neonatal outcomes .Results Cesarean operation time was （35 .62 ± 6 .64）points ,the amount of bleeding was （410 .45 ± 90 .40） mL was significantly lower than vaginal delivery group （67 .41 ± 7 .00） points ,（702 .23 ± 110 .46）mL（t= 23 .90 , 14 .46 ,P〈0 .05） .Cesarean section and vaginal delivery group set no endometritis ,wound infection ,puerperal disease and other complications of hysterectomy .5 cases of cesarean section 0-30 cases ,more than 52 cases with 7 points va‐ginal delivery group ,46 cases ,there were significant differences（χ2 =2 .46 ,2 .21 ,P〈0 .05） .Asphyxia cesarean group was 35 .00% （28/80） there is no comparison with 42 .50% vaginal delivery group （17/40） difference （χ2 =0 .948 , P〉0 .05）;cesarean group neonatal complications incidence rate of 6 .25% （5/80） ,the mortality rate was 1 .25% （1/80） was significantly lower than 22 .50% vaginal delivery group（9/40） ,the mortality rate was 7 .50% （3/40）（χ2 =9 .308 ,4 .237 ,P〈0 .05） .Conclusion In the treatment of full‐term pregnancy cesarean section for fetal distress in la‐bor ,good clinical results ,fewer complications ,maternal and newborn can have a good outcome ,improve maternal and child quality of life ,should be widely applied .