瘢痕子宫再次妊娠选择不同分娩方式的效果分析(1)
摘 要：目的 探究瘢痕子宫再次妊娠患者，使用不同分娩方式的临床效果观察。方法 选取我院2015年1月～2017年1月接收的瘢痕子宫再次妊娠产妇70例作为本次研究的对象，依据实际分娩指征分成两组，每组35例，对照组行剖宫产，研究组行阴道分娩，比较产后出血量、住院时间、产褥感染发生率、新生儿Apgar评分的效果。结果 研究组产后出血量(284.3±58.24)ml、住院时间(5.1±2.03)d优于对照组(425.7±60.24)ml、(7.2±2.20)d，产褥感染发生率2.86%低于对照组17.14%，研究组预后效果优于对照组，研究组新生儿Apgar评分正常33例优于对照组27例，差异具有统计学意义(P<0.05)。结论 在瘢痕子宫再次妊娠产妇中采取阴道分娩，不仅有利于其产后康复，降低并发症率，而且能够确保新生儿安全，值得在临床上推广。
关键词：瘢痕子宫；再次妊娠；不同分娩方式
中图分类号：R719.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.071
, 百拇医药
文章编号：1006-1959(2018)04-0186-02
Abstract：Objective To investigate the clinical effect of different modes of delivery in patients with uterine scar pregnancy.Methods 70 cases of scar pregnancy and uterus receptivity received from January 2015 to January 2017 in our hospital were selected as the objects of this study.According to the indications of actual delivery，the patients were divided into two groups of 35 cases.The control group received cesarean section，study group vaginal delivery，the effect of postpartum hemorrhage，hospitalization time，incidence of puerperal infection and neonatal Apgar score were compared.Results The postpartum hemorrhage(284.3±58.24)ml and hospital stay (5.1±2.03)d in the study group were significantly higher than those in the control group(425.7±60.24)ml and(7.2±2.20)d，respectively.The incidence of puerperal infection was 2.86% lower than that of the control group 17.14%.The prognosis of the study group was better than that of the control group.In the study group，33 cases with normal Apgar score were superior to 27 cases in the control group，the difference was statistically significant(P<0.05).Conclusion Vaginal delivery in the second trimester of cicatricial uterus is not only beneficial to the recovery of postpartum and reducing the rate of complications，but also ensures the safety of the newborn， which is worth popularizing in clinic.
, 百拇医药
Key words：Scar uterus；Pregnancy again；Different modes of delivery
剖宮产术会导致子宫壁受到损伤，并形成细小裂隙及窦道。再次妊娠时，受精卵会经过窦道进入疤痕处肌层内，使胚胎绒毛逐渐侵入到子宫肌层。如果子宫疤痕没有内膜覆盖，则胎盘、孕卵均会深入到子宫疤痕深层肌肉，容易诱发胎盘黏连，且穿越子宫壁导致大出血、子宫破裂等严重并发症[1]。当前，随着剖宫产技术的逐渐完善，及二胎政策的开发，瘢痕子宫再次妊娠比例呈现上升趋势。而怎样选择适当的分娩方式就显得非常重要。本文研究瘢痕子宫再次妊娠选择不同分娩方式的临床情况，并将我院2015年1月～2017年1月收治的70例瘢痕子宫再次妊娠产妇，实施不同分娩方案对比，现报道如下。
1资料与方法
1.1一般资料 纳入我院2015年1月～2017年1月收治的瘢痕子宫再次妊娠产妇70例作为研究对象，本次研究经过医院伦理委员会批准。所有产妇均存在剖宫产史，首次剖宫产为传统切口，并确诊为子宫瘢痕妊娠，产妇骨盆狭窄，或存在巨大儿、胎位异常等手术指征；并签署知情同意书。将所有研究对象依据实际分娩指征分成两组，每组35例，对照组年龄24～45岁，平均年龄(28.1±3.26)岁；孕周37～42周，平均孕周(38.6±3.05)周；研究组年龄23～40岁，平均年龄(28.3±3.31)岁；孕周38～42周，平均孕周(39.2±2.25)周。两组产妇一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(薛志雯)
关键词：瘢痕子宫；再次妊娠；不同分娩方式
中图分类号：R719.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.071
, 百拇医药
文章编号：1006-1959(2018)04-0186-02
Abstract：Objective To investigate the clinical effect of different modes of delivery in patients with uterine scar pregnancy.Methods 70 cases of scar pregnancy and uterus receptivity received from January 2015 to January 2017 in our hospital were selected as the objects of this study.According to the indications of actual delivery，the patients were divided into two groups of 35 cases.The control group received cesarean section，study group vaginal delivery，the effect of postpartum hemorrhage，hospitalization time，incidence of puerperal infection and neonatal Apgar score were compared.Results The postpartum hemorrhage(284.3±58.24)ml and hospital stay (5.1±2.03)d in the study group were significantly higher than those in the control group(425.7±60.24)ml and(7.2±2.20)d，respectively.The incidence of puerperal infection was 2.86% lower than that of the control group 17.14%.The prognosis of the study group was better than that of the control group.In the study group，33 cases with normal Apgar score were superior to 27 cases in the control group，the difference was statistically significant(P<0.05).Conclusion Vaginal delivery in the second trimester of cicatricial uterus is not only beneficial to the recovery of postpartum and reducing the rate of complications，but also ensures the safety of the newborn， which is worth popularizing in clinic.
, 百拇医药
Key words：Scar uterus；Pregnancy again；Different modes of delivery
剖宮产术会导致子宫壁受到损伤，并形成细小裂隙及窦道。再次妊娠时，受精卵会经过窦道进入疤痕处肌层内，使胚胎绒毛逐渐侵入到子宫肌层。如果子宫疤痕没有内膜覆盖，则胎盘、孕卵均会深入到子宫疤痕深层肌肉，容易诱发胎盘黏连，且穿越子宫壁导致大出血、子宫破裂等严重并发症[1]。当前，随着剖宫产技术的逐渐完善，及二胎政策的开发，瘢痕子宫再次妊娠比例呈现上升趋势。而怎样选择适当的分娩方式就显得非常重要。本文研究瘢痕子宫再次妊娠选择不同分娩方式的临床情况，并将我院2015年1月～2017年1月收治的70例瘢痕子宫再次妊娠产妇，实施不同分娩方案对比，现报道如下。
1资料与方法
1.1一般资料 纳入我院2015年1月～2017年1月收治的瘢痕子宫再次妊娠产妇70例作为研究对象，本次研究经过医院伦理委员会批准。所有产妇均存在剖宫产史，首次剖宫产为传统切口，并确诊为子宫瘢痕妊娠，产妇骨盆狭窄，或存在巨大儿、胎位异常等手术指征；并签署知情同意书。将所有研究对象依据实际分娩指征分成两组，每组35例，对照组年龄24～45岁，平均年龄(28.1±3.26)岁；孕周37～42周，平均孕周(38.6±3.05)周；研究组年龄23～40岁，平均年龄(28.3±3.31)岁；孕周38～42周，平均孕周(39.2±2.25)周。两组产妇一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(薛志雯)