摘要
目的:分析剖宫产从决定手术至胎儿娩出时间(DDI)的影响因素,以及急诊剖宫产DDI对新生儿预后的影响。方法:对472例剖宫产患者根据Lucas分类法分为两组:急诊剖宫产组(291例)与非急诊剖宫产组(181例);急诊剖宫产组中分为DDI≤30分钟组和DDI>30分钟组,分别回顾性分析影响DDI的重要因素、以及DDI对新生儿Apgar评分及脐动脉血气的影响。结果:①急诊剖宫产组的DDI为35.5±11.6分钟,其中210例(72.2%)DDI≤30分钟;非急诊剖宫产组DDI为49.3±22.8分钟,其中86例(47.5%)DDI≤30分钟;②急诊剖宫产组中,与DDI>30分钟相比,DDI≤30分钟可明显改善新生儿脐动脉血pH值以及1分钟Apgar评分(P<0.05);但5分钟Apgar评分比较,两组差异无统计学意义(P>0.05);③DDI>30分钟的主要原因为将孕妇由产房或待产室运送至手术室的耗时(56例,69.1%)。结论:并非所有急诊剖宫产手术均能达到DDI≤30分钟的标准,尽量缩短DDI时间有助于最终改善新生儿预后。
Objective：To assess the influential factors of decision-to-delivery interval（DDI）in caesarean section,and its influence on neonatal outcomes.Methods：472 caesarean sections were divided into two groups according to Lucas＇s classification：the emergency caesarean sections as group 1（291）;and the elective caesarean sections as group 2（181）.It was divided into DDI ≤30 min group and DDI 30 min group in group 1.A retrospective study was performed in DDI,influential factors of DDI,neonatal Apgar score and umbilical arterial blood gas.Results：①The mean DDI was 35.5±11.6 min in group 1,in which DDI≤30 min was 210 cases（72.2%）and 49.3±22.8 min in group 2,in which DDI≤30 min was 86 cases（47.5%）.②In group 1,umbilical artery pH and Apgar score at 1 min after birth could be improved significantly in the cases of DDI≤30 min（P0.05）,but no correlation was found between the DDI and Apgar score at 5 min,as compared with DDI30min cases（P0.05）.③It was mainly influenced by the time taken to get the patient into operation room in DDI30 min（56 cases,69.1%）.Conclusions：The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as possible might improve the neonatal outcome.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2010年第4期276-278,共3页
Journal of Practical Obstetrics and Gynecology
