顺产和剖宫产对母婴健康的影响比较
|
摘要
目的对比分析顺产和剖宫产对母婴健康的影响。方法选取2016年1月至2018年1月于本院进行生产的80例产妇进行研究,按照分娩方式的不同进行分组,将其中40例顺产者作为观察组,另外40例剖宫产者作为对照组,对比两组产后恢复情况及新生儿体质状况。结果在产妇健康方面,观察组产后出血量明显少于对照组,24 h宫高水平高于对照组,下床活动时间、肠道恢复时间以及住院时间、母乳开始时间均短于对照组,差异有统计学意义(P<0.05),且观察组产后泌乳不足、产后出血、产褥病率、产后便秘、尿潴留以及切口延期愈合等并发症发生率均低于对照组,差异有统计学意义(P<0.05);在新生儿健康方面,观察组新生儿乳酸水平明显高于对照组,胆红素指数低于对照组,Apgar评分高于对照组,差异有统计学意义(P<0.05),且观察组新生儿窒息、新生儿肺炎发生率以及Apgar评分≤7分者明显低于对照组,差异有统计学意义(P<0.05)。结论相比顺产,剖宫产对母婴健康的影响较大,医护人员应谨慎选择产妇分娩方式,建议产妇选择对自身及婴儿健康程度损伤性小的分娩方式,以顺产为主。
Objective To compare the effect of spontaneous labor and Cesarean section in the maternal and child health. Methods 80 puerpera delivered from January 2016 to January 2018 in our hospital were selected and assigned to observation group(n=40) and control group(n=40) according to the delivery modes. The observation group received the spontaneous labor; the control group received the Cesarean section. The postpartum recovery conditions and neonatal state were probed. Results Compared with control group, the observation group had the smaller postpartum bleeding volume, larger fundal height after 24 h of postpartum as well as shorter initial ambulant time, gastrointestinal recovery time, hospitalization time, and initial lactation time; the difference was statistically significant(P<0.05); the incidence rate of insufficient lactation, postpartum hemorrhage, puerperalism, postpartum constipation, urinary retention and delayed wound healing in the observation group was lower than control group,with statistically significant difference(P<0.05); compared with control group, the neonates in the observation group had the higher lactic acid levels, lower bilirubin index and higher Apgar scores; the difference was statistically significant(P<0.05); the incidence rate of neonatal asphyxia and pneumonia and rate with Apgar scores ≤7 in the observation group was lower than control group, with statistically significant difference(P<0.05).Conclusion The Cesarean section has larger effect in the maternal and child health. Thus the medical staff shall take a serious consideration on the proper delivery modes in having less impact in the maternal and child health. The spontaneous labor can be primarily recommended.
Objective To compare the effect of spontaneous labor and Cesarean section in the maternal and child health. Methods 80 puerpera delivered from January 2016 to January 2018 in our hospital were selected and assigned to observation group(n=40) and control group(n=40) according to the delivery modes. The observation group received the spontaneous labor; the control group received the Cesarean section. The postpartum recovery conditions and neonatal state were probed. Results Compared with control group, the observation group had the smaller postpartum bleeding volume, larger fundal height after 24 h of postpartum as well as shorter initial ambulant time, gastrointestinal recovery time, hospitalization time, and initial lactation time; the difference was statistically significant(P<0.05); the incidence rate of insufficient lactation, postpartum hemorrhage, puerperalism, postpartum constipation, urinary retention and delayed wound healing in the observation group was lower than control group,with statistically significant difference(P<0.05); compared with control group, the neonates in the observation group had the higher lactic acid levels, lower bilirubin index and higher Apgar scores; the difference was statistically significant(P<0.05); the incidence rate of neonatal asphyxia and pneumonia and rate with Apgar scores ≤7 in the observation group was lower than control group, with statistically significant difference(P<0.05).Conclusion The Cesarean section has larger effect in the maternal and child health. Thus the medical staff shall take a serious consideration on the proper delivery modes in having less impact in the maternal and child health. The spontaneous labor can be primarily recommended.
引文
[1]李严平,陈沂,刘春霞,等.不同分娩方式对母婴健康影响的Meta分析[J].中国医刊,2015,50(9):87-93.
[2]王桂兰.剖宫产对母婴近远期的影响[J].中国基层医药,2013,20(11):1631-1633.
[3]陈晓琴,罗晓菊,吕行,等.不同分娩方式对第二产程延长母婴结局的分析[J].中国妇幼健康研究,2015,26(1):69-70,94.
[4]陈勇.瘢痕子宫再次妊娠不同分娩方式对母婴影响研究[J].四川医学,2015,36(8):1168-1170.
[5]刘会玲.不同分娩方式妊娠结局及降低剖宫产率的干预措施[J].陕西医学杂志,2016,45(8):1051-1052.
[6]郝玉萍.剖宫产术后再次妊娠不同分娩方式对母婴结局的影响[J].中国妇幼保健,2017,32(11):2328-2330.
[7]蒙春莲,潘莲花.HIV/AIDS孕妇经HAART后不同分娩方式对母婴传播的影响[J].广西医学,2015,37(3):401-402.
[8]李红雨,王丹,常青,等.不同分娩方式对低危产妇母婴围生期结局的影响[J].中华妇幼临床医学杂志(电子版),2016,12(6):715-719.
[9]赵新敏,高云霞,张举,等.不同分娩方式对不同HBV DNA载量乙型肝炎母婴垂直传播的影响[J].中华医院感染学杂志,2017,27(2):422-424.
[10]王艳,朱相干.不同分娩方式对剖宫产术后再次妊娠产妇分娩结局以及新生儿结局的影响[J].中国妇幼保健,2018,33(14):3212-3215.
[11] Waleed El-Khayat, Mohamed Elsharkawi, Amr Hassan,et al. A randomized controlled trial of uterine ex-teriorization versus in situ repair of the uterineincision during cesarean delivery[J]. Internationaljournal of gynecology and obstetrics:the officialorgan of the International Federation of Gynaecolo-gy and Obstetrics, 2014,127(2):163-166.
[2]王桂兰.剖宫产对母婴近远期的影响[J].中国基层医药,2013,20(11):1631-1633.
[3]陈晓琴,罗晓菊,吕行,等.不同分娩方式对第二产程延长母婴结局的分析[J].中国妇幼健康研究,2015,26(1):69-70,94.
[4]陈勇.瘢痕子宫再次妊娠不同分娩方式对母婴影响研究[J].四川医学,2015,36(8):1168-1170.
[5]刘会玲.不同分娩方式妊娠结局及降低剖宫产率的干预措施[J].陕西医学杂志,2016,45(8):1051-1052.
[6]郝玉萍.剖宫产术后再次妊娠不同分娩方式对母婴结局的影响[J].中国妇幼保健,2017,32(11):2328-2330.
[7]蒙春莲,潘莲花.HIV/AIDS孕妇经HAART后不同分娩方式对母婴传播的影响[J].广西医学,2015,37(3):401-402.
[8]李红雨,王丹,常青,等.不同分娩方式对低危产妇母婴围生期结局的影响[J].中华妇幼临床医学杂志(电子版),2016,12(6):715-719.
[9]赵新敏,高云霞,张举,等.不同分娩方式对不同HBV DNA载量乙型肝炎母婴垂直传播的影响[J].中华医院感染学杂志,2017,27(2):422-424.
[10]王艳,朱相干.不同分娩方式对剖宫产术后再次妊娠产妇分娩结局以及新生儿结局的影响[J].中国妇幼保健,2018,33(14):3212-3215.
[11] Waleed El-Khayat, Mohamed Elsharkawi, Amr Hassan,et al. A randomized controlled trial of uterine ex-teriorization versus in situ repair of the uterineincision during cesarean delivery[J]. Internationaljournal of gynecology and obstetrics:the officialorgan of the International Federation of Gynaecolo-gy and Obstetrics, 2014,127(2):163-166.