王长祺

[摘要] 目的 探讨分析疤痕子宫经产妇再次妊娠进行阴道试产以及采用剖宫产的不同效果。 方法 整群选取2013年9月—2015年3月间该院妇产科收治的135例疤痕子宫的再次妊娠产妇，与同期收治的127例初产妇来作为研究对象，并将根据产妇情况分为疤痕组与初产组，然后统计并对比这两组妊娠产妇的分娩情况。 结果 采取阴道分娩取得成功的疤痕组产程为（8.87±1.56）h，生产时的出血量为（152.23±20.56）mL，其新生婴儿的Apgar评分为（9.06±0.44）分；与采用阴道分娩取得成功的初产组对比，差异无统计学意义（P>0.05）；瘢痕组的产妇进行手术时间、产后的出血量和住院的时间等指标明显优于疤痕组产妇，差异有统计学意义（P<0.05）。 结论 针对部分适合采取阴道试产方式有疤痕子宫的经产妇，应以最大程度地降低疤痕子宫经产妇的剖宫产率，达到优化妊娠产妇分娩的结局，提高该院妇产科工作的服务质量。

[关键词] 疤痕子；阴道试产；剖宫产

[中图分类号] R473.72 [文献标识码] A [文章编号] 1674-0742（2016）02（b）-0079-02

[Abstract] Objective To discuss and analyze the different effects of vaginal trial production and caesarean section for scared uterus multiparae with repeated pregnancy. Methods 135 cases of puerpera with scared uterus and repeated pregnancy treated in the obstetrics and gynecology department in our hospital from September 2013 to March 2015 and 127 cases of primiparae treated in our hospital at the same period were selected as the research object and divided into the scared group and the primipara group according to the puerperas conditions， the delivery conditions of the two groups were counted and compared. Results By successful vaginal delivery， the birth process， blood loss during delivery and Apgar score in neonates in the scared group were respectively （8.87±1.56）h，（152.23±20.56）ml and（9.06±0.44）marks， there was no obvious difference compared with those in the primipara group， （P>0.05）， the difference was not statistically significant， the indicators such as the operation time， postoperative blood loss and length of stay in the primipara group were obviously better than those in the scared group， the differenced were obvious （P<0.05）， with statistically significance. Conclusion We should reduce the cesarean section rate to the most extent of some multiparae with scared uterus who are suitable for vaginal trial production to optimize the delivery outcome and improve the service quality of obstetrics and gynecology department in our hospital.

[Key words] Scared uterus； Vaginal trial production；Caesarean section

近两年来，我们国家计划生育政策的放宽，很多家庭选择了生育第二个孩子，因此，疤痕子宫二次妊娠的发生率也在不断上升。所以，对于疤痕子宫的再次妊娠产妇来说，如何选择合适的分娩方式是迫在眉睫的问题，也是医院临床医师以及产妇家人均密切关注的大问题[1]。在该研究当中，为了更好地研究疤痕子宫的再次妊娠产妇采取进行阴道试产或者采取剖宫产的临床妊娠效果，整群选取2013年9月—2015年3月间该院妇产科收治的135例疤痕子宫的再次妊娠产妇，与同期妇产科所收治的127例初产妇来作为研究对象，并将根据产妇情况分为疤痕组与初产组，依据两组产妇的综合妊娠情况，为产妇提供合理的分娩方式，认真观察并对比这两组妊娠产妇的分娩情况，回顾性分析对比两组产妇的人生结果与分娩情况，现报道如下。