中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2010, Vol. 39 ›› Issue (2): 140–.

• 临床医学 • 上一篇    下一篇

行产时胎儿手术的母体预后分析

乔宠; 张志涛; 刘彩霞; 李秋玲; 周阳子; 陈卫民; 王维林; 黄英; 毛健; 富建华   

  1. 中国医科大学附属盛京医院妇产科; 中国医科大学附属盛京医院麻醉科; 中国医科大学附属盛京医院小儿外科; 中国医科大学附属盛京医院新生儿外科; 中国医科大学附属盛京医院新生儿内科
  • 出版日期:2010-02-27 发布日期:2013-06-07
  • 通讯作者: 刘彩霞 E-mail:liucx@sj hospital.org

The Maternal Prognosis after Intrapartum Fetal Operation Performation

  • Online:2010-02-27 Published:2013-06-07

摘要:

目的通过分析行产时胎儿手术的母体预后,探讨产时胎儿手术的可行性、安全性及预防产后出血,保证母体良好预后的有效措施。方法回顾性分析2008年8月至2009年10月我院成功施行产时胎儿手术的10例患者[产时胎儿手术组(IFO组),n=10]术中及术后24h内出血量,术前和术后24h的血红蛋白水平、宫缩情况、产褥感染的发生情况,产后42d随访情况并与同期因拒绝试产行择期剖宫产手术的10例健康孕妇(对照组)进行各项指标比较。结果两组患者的子宫复旧情况均正常,均无早期及晚期产后出血及产褥感染发生。IFO组母体术中出血量、术后24h及术中+术后24h总出血量、术前和术后及产后42d复查的血红蛋白浓度与对照组相比均无统计学差异(P>0.05)。IFO组剖宫产术时间为(66.40±53.40)min,与对照组(34.50±4.97)min相比未见统计学差异(P<0.05)。术中出血量、术后24h内产后出血量及术中+术后24h出血量均与患者的年龄和孕周无相关(P>0.05),而与剖宫产术时间呈正相关(r=0.458,P=0.021),其线性回归方程为:Y(ml)=172.68+1.342X。结论产时胎儿手术对于母体的子宫复旧无明显影响,不增加产后出血量及产褥感染发生率,对母体是安全的。采用积极有效的预防措施可以使产时手术的孕产妇的产后出血量并不明显超过普通剖宫产术,积极提高胎儿手术技术,尽量缩短产时手术时间也是预防母体产后出血的一项重要措施。

关键词: 产时胎儿手术, 母体预后, 产时胎儿手术, 母体预后

Abstract:

Objective To investigate the feasibility,security,indication and
      prophylactic measures of postpartum hemorrhage during the fetal
      intrapartum operation by analyze the maternal prognosis after intrapartum
      fetal operation(IFO)performed.Methods We performed a retrospective
      evaluation of 10 cases that has been performed intrapartum fetal
      operation(IFO group,n =10)successfully between August 2008 and October
      2009 at Department of Obstetrics and Gynecology,Shengjing Hospital,China
      Medical University.Healthy pregnant women(n = 10)were chosen as control
      group,who received Caesarean section for refusing to vaginal
      delivery.Between the two groups,we compared the indexes including blood
      lose during the operation and 24 hours post-operation,the hemoglobin level
      pre-operation and 24 hours post-operation,the involution of uterus,the
      puerperal infection,and the follow-up at 42 days post-operation.Results
      Good involution,no primary and secondary postpartum hemorrhage and no
      puerperal infection were found in both of the 2
      groups.Intra-operation,24 hours post-operation and the total volumes of
      blood lose,the hemoglobin level before operation,24 hours post-operation
      and 42 days post-operation had no statistic significant difference between
      the IFO group and control group(P > 0.05).No significant difference was
      found in the operation time between IFO group and the control
      group(66.40±53.40 minutes and 34.50±4.97
      minutes,respectively.Intra-operation,24 hours post-operation and the total
      volume of blood lose had no relation to the maternal age and gestational
      weeks(P > 0.05).The blood lose of intra-operation in IFO group had
      positive linear correlation to the operation time(.Pearson relation
      coefficient R=0.458,P =0.021).The linear recurrence equation was:the
      volumes of blood lose intra-operation(ml)= 172.68+1.342×(operation
      time).Conclusion IFO was safe to the mother.It did not affect the
      involution of uterus and could not increase the blood lose of postpartum
      and the puerperal infection morbidity.Through the effective measures of
      preventing postpartum hemorrhage,the postpartum blood lose of the patients
      that performed intrapartum fetal operation could be no more than that of
      the patients that had normal Caesarean section.Improving the technique of
      the intrapartum fetus operation and shortening the operation time are
      important to prevent postpartum hemorrhage.

Key words: intrapartum fetal operation, maternal prognosis, intrapartum fetal operation, maternal prognosis

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