保留胎膜囊剖宫产术在早产双胎妊娠中的应用评价

Application of cesarean section with preserved fetal membrane sac in premature delivery of twin-pregnant women

  • 摘要:
    目的  探讨保留胎膜囊剖宫产术在早产双胎妊娠中的应用价值。
    方法  回顾性分析2019—2021年在苏北人民医院因早产行保留胎膜囊剖宫产术分娩的20例双胎孕妇(观察组)的临床资料, 另选取同期收治的30例早产行常规新式子宫下段剖宫产术分娩的双胎孕妇为对照组。分析不同术式在手术时间、羊水量、术中出血量、新生儿Apgar评分、新生儿出生体质量、新生儿窒息等方面的差异; 比较保留胎膜囊剖宫产术与常规新式子宫下段剖宫产术在手术指标及妊娠结局方面的差异。
    结果  观察组手术时间为(37.63±10.85)min, 短于对照组的(50.00±10.50)min, 差异有统计学意义(P < 0.05);观察组术中出血量为(384.21±229.16)mL, 多于对照组的(373.33±163.86)mL, 但差异无统计学意义(P>0.05)。完全保留胎膜囊娩出的新生儿平均肌酸激酶水平为(247.50±85.19)U/dL, 低于对照组的(311.35±138.03)U/dL, 差异有统计学意义(P < 0.05)。保留胎膜囊剖宫产术与常规新式子宫下段剖宫产术在术中出血量及新生儿窒息方面比较,差异无统计学意义(P>0.05)。
    结论  保留胎膜囊剖宫产术能缩短手术时间,有利于改善早产双胎妊娠的结局,可能对减轻早产儿心肌损伤有积极的作用。

     

    Abstract:
    Objective  To explore application value of cesarean section with preserved fetal membrane sac in premature delivery of twin-pregnant women.
    Methods  The clinical data of 20 twin-pregnant women who performed cesarean section with preserved fetal membrane sac due to premature delivery in North Jiangsu People's Hospital from 2019 to 2021 were retrospectively analyzed. Another 30 twin-pregnant women who performed conventional lower uterine section for delivery in twin-pregnant women in the same period were selected as control group. The differences of operation time, amniotic fluid volume, intraoperative blood loss, neonatal Apgar score, neonatal birth weight, neonatal asphyxia and other aspects were analyzed. The differences of surgical indicators and pregnancy outcomes between cesarean section with preserved fetal membrane sac and conventional new lower uterine were compared.
    Results  The average operation time of the observation group was (37.63±10.85) min, which was significantly shorter than (50.00±10.50) min in the control group(P < 0.05). The intraoperative blood loss in the observation group was (384.21±229.16) mL, which was more than (373.33±163.86) mL in the control group, but no significant difference was observed (P>0.05). The mean creatine kinase level in neonates with completely preserved fetal sac was (247.50±85.19) U/dL, which was lower than (311.35±138.03) U/dL in the control group and the difference was statistically significant (P < 0.05). There were no significant differences in intraoperative blood loss and neonatal asphyxia between cesarean section with preserved fetal membrane sac and conventional new lower uterine section (P>0.05).
    Conclusion  Cesarean section with preserved fetal membrane sac can shorten operation time, improve the outcome of premature twin pregnancy, and may have a positive effect in reducing myocardial injury in premature infants.

     

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