急诊剖宫产以及择期剖宫产产妇的临床特征比较

Clinical features of emergency cesarean section and elective cesarean section puerperae

目的观察并比较急诊剖宫产以及择期剖宫产产妇的临床特征。方法选取本院2011年1月至2015年1月间收治的行剖宫产产妇共718例，根据手术开始时间和发动分娩以及破膜之间关系将其分为择期剖宫产组以及急诊剖宫产组，其中急诊剖宫产组中317例作为观察组，择期剖宫产中401例作为对照组，对其临床特征进行回顾性分析。结果观察组的手术指征前4位为头盆不称、宫缩乏力、活跃期停滞、宫内胎儿窘迫，对照组中手术指征的前4位为宫内胎儿窘迫、骨盆狭窄、臀位以及瘢痕子宫。观察组的手术时间、术中出血量以及肛门排气时间均明显长于对照组，对照组的腹部切口感染、新生儿窒息、取头困难、子宫切口撕裂、术后发热的发生率均明显低于观察组，组间比较差异有统计学意义（P〈0．05）。结论急诊剖宫产对产妇的危害更大，在临床上需要予以重视，尽可能减少急诊剖宫产的几率，避免严重并发症的发生。

Objective To observe and compare the clinical features of emergency cesarean section and elective cesarean section puerperae. Methods 718 puerperae who received cesarean section from January 2011 to January 2015 were selected, and divided into elective cesarean section group （401 cases, control group） and emergency cesarean section group （317 cases, observation group） according to operation start time and the relationship between delivery start and rupture. Clinical features were retrospectively analyzed. Results The former four surgical indications in observation group were cephalopelvic disproportion, uterine inertia, protracted active phase, fetal distress; the former four surgical indications in control group were fetal distress, contracted pelvis, breech presentation, scarred uterus. The operation time, intraoperative blood loss and anus exhaust time in observation group were significantly longer than those in control group, the incidences of abdominal incision infection, neonatal asphyxia, delivering the fetal head with difficultly, uterus incision laceration, postoperative fever in control group were significantly lower than those in observation group, with statistically significant differences between two groups （P〈0.05）. Conclusion The maternal harm of emergency cesarean delivery is serious. We should attach importance to reduce the rate of emergency cesarean delivery as far as possible to avoid serious complications.