| 何瑞芝,童重新,尹红亚,尚 清,李军霞.急诊危重孕产妇5分钟紧急剖宫产的临床效果及新生儿不良结局的危险因素分析[J].,2023,(22):4359-4363 |
| 急诊危重孕产妇5分钟紧急剖宫产的临床效果及新生儿不良结局的危险因素分析 |
| Analysis of the Clinical Effect of 5 Minutes Emergency Cesarean Section for Emergency Critical Pregnant and Postpartum Women in Emergency Department and the Risk Factors of Adverse Neonatal Outcomes |
| 投稿时间：2023-04-02 修订日期：2023-04-26 |
| DOI：10.13241/j.cnki.pmb.2023.22.032 |
| 中文关键词: 急诊危重孕产妇 5分钟紧急剖宫产 临床疗效 新生儿不良结局 影响因素 |
| 英文关键词: Diagnosing critically ill pregnant and postpartum women 5 minute emergency cesarean section Clinical efficacy Adverse neonatal outcomes Influence factor |
| 基金项目:河北省医学科学研究课题计划（20190814） |
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| 中文摘要: |
| 摘要 目的：探讨急诊危重孕产妇5分钟紧急剖宫产的临床效果，并分析新生儿不良结局的危险因素。方法：回顾性分析2018年1月~2022年6月在河北省儿童医院妇产科收治的急诊危重孕产妇139例的临床资料。根据急诊剖宫产流程分为对照组（n=68，常规紧急剖宫产流程下进行手术）及观察组（n=71，5分钟紧急剖宫产）。观察两组孕产妇的手术情况、手术反应时间、孕产妇并发症、新生儿不良结局发生率。采用多因素Logistic回归模型分析新生儿不良结局的危险因素。结果：两组住院时间、术中出血量、术中输血情况组间对比，未见统计学差异（P>0.05）。与对照组相比，观察组进手术室至手术开始时间、决定手术至胎儿娩出的时间间隔（DDI）、决定手术至进手术室时间、手术开始至胎儿娩出时间均更短，新生儿不良结局发生率、并发症发生率更低（P<0.05）。根据新生儿不良结局将孕产妇分为不良组（n=38）、良好组（n=101）。单因素分析结果显示：新生儿不良结局与受教育程度、新生儿体重、孕周、剖宫产类型、DDI、妊娠合并症、采用辅助生殖技术有关（P<0.05）。多因素Logistic回归分析结果显示，受教育程度为小学及其以下、新生儿体重偏低、剖宫产类型为I类剖宫产、孕周偏短、DDI偏长均是新生儿不良结局的危险因素（P<0.05）。结论：急诊危重孕产妇5分钟紧急剖宫产可缩短各项手术反应时间，降低孕产妇并发症和新生儿不良结局发生率。此外，新生儿不良结局的发生与受教育程度、新生儿体重、剖宫产类型、孕周、DDI等因素有关。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical effect of 5 minutes emergency cesarean section for emergency critical pregnant and postpartum women, and to analyze the risk factors of adverse neonatal outcomes. Methods: The clinical data of 139 emergency critical pregnant and postpartum women who were admitted to the Department of Gynaecology and Obstetrics of Hebei Provincial Children's Hospital from January 2018 to June 2022 were retrospectively analyzed. Patients were divided into control group (n=68, surgery under the routine emergency cesarean section process) and observation group (n=71, 5 minute emergency cesarean section) according to the emergency cesarean section process. The operation conditions, operation reaction time, maternal complications, adverse neonatal outcomes were observed in two groups. The risk factors of adverse neonatal outcomes were analyzed by multivariate Logistic regression model. Results: There was no significant difference in hospitalization time, intraoperative blood loss and intraoperative blood transfusion between two groups(P>0.05). Compared with control group, time from entering the operating room to the beginning of the operation, Decision to delivery interval(DDI), time from the decision to enter the operating room and time from the beginning of the operation to the delivery of the fetus in observation group were shorter, and the incidence of adverse neonatal outcomes and complications were lower (P<0.05). The pregnant women were divided into poor group (n=38) and good group(n=101) according to the adverse neonatal outcomes. The results of univariate analysis showed that: adverse neonatal outcomes were related to education level, neonatal weight, gestational week, type of cesarean section, DDI, pregnancy complications and use of assisted reproductive technology(P<0.05). Multivariate Logistic regression analysis showed that, primary school education and below, low neonatal weight, type I cesarean section, shorter gestational week and longer DDI were risk factors for adverse neonatal outcomes (P<0.05). Conclusion: 5 minutes emergency cesarean section for emergency critical pregnant and postpartum women can shorten the reaction time of various operations and reduce the incidence of maternal complications and adverse neonatal outcomes. In addition, the occurrence of adverse neonatal outcomes is relate to factors such as education level, neonatal weight, type of cesarean section, gestational week and DDI. |
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