杨卫华 英晓菲 梁小菊

[摘要]目的 探討高龄孕产妇分娩方式与妊娠结局的关系。方法 回顾性分析2017年8月～2019年6月在我院分娩高龄产妇120例的临床资料，按照分娩方式不同分为阴道分娩组、剖宫产分娩组，每组各60例。比较两组分娩时疼痛程度、心理状态、产后出血量、分娩后卧床时间及新生儿Apgar评分。结果 阴道分娩组视觉模拟量表（VAS）评分、抑郁自评量表（SDS）和焦虑自评量表（SAS）评分分别为（8.37±1.42）、（37.28±4.31）、（40.45±4.42）分，高于剖宫产分娩组的（3.75±0.42）、（26.59±3.48）、（28.59±3.27）分，差异均有统计学意义（P<0.05）;阴道分娩组分娩后卧床时间为（1.85±0.57）d，短于剖宫产分娩组的（4.85±0.48）d，差异有统计学意义（P<0.05）;阴道分娩组产后出血量为（232.96±12.65）ml，少于剖宫产分娩组的（381.96±23.67）ml，差异有统计学意义（P<0.05）;两组新生儿Apgar评分比较，差异无统计学意义（P>0.05）。结论 高龄孕产妇剖宫产和阴道分娩对新生儿无明显影响，前者分娩时疼痛轻微、心理状况佳，但产后出血量多、卧床时间长，各有优缺点，可根据产妇情况选择适宜的分娩方式。

[关键词]高龄产妇;分娩方式;妊娠结局;心理状态;疼痛程度

[中图分类号] R473.71          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0129-03

Effect of delivery mode on the outcome of pregnancy in elderly pregnant women

YANG Wei-hua   YING Xiao-fei    LIANG Xiao-ju

Department of Obstetrics， Shenzhen Hospital of University of Chinese Academy of Sciences （Guangming）， Guangdong Province， Shenzhen   518000， China

[Abstract] Objective To explore the relationship between delivery mode and pregnancy outcome of elderly pregnant women. Methods The clinical data of 120 elderly pregnant women who delivered in our hospital from August 2017 to June 2019 were analyzed retrospectively. According to the different modes of delivery， they were divided into vaginal delivery group and cesarean delivery group， 60 cases in each group. The pain degree， psychological state， postpartum hemorrhage， lying in time after delivery and Apgar score of newborn were compared between two groups. Results The scores of visual analogue scale （VAS）， self-rating depression scale （SDS） and self-rating anxiety scale （SAS） in vaginal delivery group were （8.37±1.42）， （37.28±4.31）， （40.45±4.42） points， which were higher than those in cesarean delivery group for （3.75±0.42）， （26.59±3.48）， （28.59±3.27） points， the differences between the two groups were statistically significant （P<0.05）; the time of lying in bed was （1.85±0.57） d， shorter than that in the perinatal intervention group for （4.85±0.48） d， the difference between the two groups was statistically significant （P<0.05）. The amount of postpartum hemorrhage in vaginal delivery group was （232.96±12.65） ml， was less than （381.96±23.67） ml in cesarean delivery group， the difference was statistically significant （P<0.05）. There was no significant difference in Apgar score between the two groups （P>0.05）. Conclusion Cesarean section and vaginal delivery have no significant effect on the newborn. The former has mild pain and good psychological condition， but with more amount of postpartum hemorrhage and long time in bed. Each has advantages and disadvantages appropriate delivery can be selected under.

[Key words] Elderly pregnant women; Delivery mode; Pregnancy outcome; Psychological state; Pain intensity

高龄孕产妇指妊娠年龄在35岁及以上女性，随着我国“二孩”政策全面开放、晚婚晚育政策的推行、女性生育观念的改变、高离婚率和高再婚率、“单独二孩”政策全面开放、独生子女因病或意外死亡、“丁克”家庭生育观念改变因素影响，高龄孕产妇比例越来越高[1-2]。高龄孕产妇生殖器官功能、自身机体功能处于下降状态，子宫收缩力和阴道伸张力欠佳，不仅增加产妇恐惧和紧张感，还提高分娩的风险性[3-4]。对高龄孕产妇，选择适宜分娩方式至关重要，多数高龄孕产妇倾向于剖宫产分娩，但会损伤产妇身体，产后恢复较慢，延长卧床时间[5]。本研究回顾性分析在我院分娩120例高龄孕产妇临床资料，旨在分析高龄孕产妇分娩方式与妊娠结局的关系，现报道如下。……