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(jī)分為對(duì)照組（30例）和觀察組（27例）。對(duì)照組采用剖宮產(chǎn)分娩， 觀察組采用陰道試產(chǎn)分娩。比較兩組住院時(shí)間、新生兒體質(zhì)量、出血量、Apgar評(píng)分及產(chǎn)褥感染、新生兒窒息、子宮破裂發(fā)生情況。結(jié)果 兩組新生兒體質(zhì)量、Apgar評(píng)分比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;觀察組出血量（159.5±19.3）ml少于對(duì)照組的（278.5±41.6）ml， 住院時(shí)間（4.5±1.9）d短于對(duì)照組的（7.5±1.3）d， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者均未發(fā)生子宮破裂。觀察組產(chǎn)褥感染、新生兒窒息發(fā)生率分別為0、3.70%， 均低于對(duì)照組的13.33%、23.33%， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)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(jié)局， 值得推廣應(yīng)用。

【關(guān)鍵詞】 瘢痕子宮;陰道分娩;剖宮產(chǎn)分娩;護(hù)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(chǎn)科臨床治療的難點(diǎn)， 且在妊娠、分娩過(guò)程中容易引發(fā)大出血、子宮破裂等不良情況[1]。剖宮產(chǎn)是瘢痕子宮患者中常用的終止妊娠的方法， 能搶救產(chǎn)婦、新生兒生命， 成為不可經(jīng)陰道分娩者的重要補(bǔ)救手段。但是， 隨著醫(yī)療水平的不斷發(fā)展， 人們的分娩觀念發(fā)生轉(zhuǎn)變， 由于剖宮手術(shù)對(duì)母體損傷相對(duì)較大， 術(shù)后容易出現(xiàn)各種并發(fā)癥， 且剖宮產(chǎn)是子宮瘢痕形成的主要原因。因此， 加強(qiáng)瘢痕子宮再次妊娠患者陰道分娩對(duì)改善產(chǎn)婦身心健康具有重要的意義， 但是對(duì)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(duì)象， 探討瘢痕子宮再次妊娠患者陰道分娩的安全性， 報(bào)告如下。