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find Keyword "剖宫产" 46 results
  • 剖宫产术中迷走神经反射致严重心律失常两例

    Release date:2021-04-15 05:32 Export PDF Favorites Scan
  • 子宫峡部剖宫产切口部位妊娠的彩色多普勒超声诊断分析

    目的探讨子宫峡部剖宫产切口部位妊娠的彩色多普勒超声声像图特点,为临床诊疗提供有价值的参考依据。 方法选取2011年8月-2013年7月诊断的12 例子宫峡部剖宫产切口部位妊娠的患者作为研究对象,回顾性分析其彩色多普勒超声声像图特点及临床资料。 结果12例患者中5例停经时间短、妊娠囊较小,位置完全位于子宫峡部切口处因声像图典型而确诊;3例因停经时间长、妊娠囊大部分位于宫腔内,少部分位于切口处误诊为宫内孕;2例切口妊娠流产,误诊不全流产;另外2例因院外人工流产术后阴道流血增多就诊,诊断为切口妊娠。 结论彩色多普勒超声对子宫峡部剖宫产切口妊娠的诊断具有准确性、可靠性。

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  • 剖宫产术后宫底免盐袋加压对产妇出血量及舒适度的影响

    目的探讨剖宫产术后宫底免盐袋加压对产妇出血量及舒适度的影响。 方法将2012年7月-12月行剖宫产手术的正常初产妇122例随机分为2组,观察组(n=60)术毕不给予盐袋加压,对照组(n=62)常规在宫底部加压1 kg的盐袋,持续6 h,两组其他治疗、护理措施相同。记录两组产妇术后6 h内阴道出血量和呕吐次数,肛门排气时间及产妇主观舒适度。 结果两组产妇术后6 h内阴道出血量[(167.23±31.65)、(178.75±37.42)mL;t=1.833,P=0.069)和呕吐次数(Z=-0.740,P=0.459)比较,差异无统计学意义;观察组主观舒适度明显高于对照组(Z=-4.353,P=0.000);观察组肛门排气时间[(14.45±4.55)d]比对照组[(21.95±6.06)d]明显缩短(t’=-7.747,P=0.000)。 结论剖宫产术后如未发生产后大出血,宫底免盐袋加压治疗可增加产妇舒适度,促进肠功能的恢复。

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  • Chewing Gum in Promoting Bowel Recovery after Cesarean Section: A Systematic Review

    Objective To assess the efficacy and safety of chewing gum in promoting bowel recovery after cesarean section. Methods Such databases as The Cochrane Library, MEDLINE, EMbase and CBM were searched from their establishment to 2010 to include the randomized controlled trials (RCTs) of comparing chewing gum with other procedures for promoting postoperative bowel function after cesarean section. The risks of bias in the included studies were evaluated at randomization, allocation concealment, blinding, completeness of outcomes, and selective reporting. Meta-analyses were performed by RevMan 5.0.22 software. Results Three RCTs involving 745 participants were included. The results of meta-analyses showed chewing gum after cesarean section significantly shortened the time before getting the first postoperative flatus (MD= –6.54, 95%CI –7.82 to –5.27, Plt;0.000 01), reduced the risks of postoperative ileus (RR=0.54, 95%CI 0.34 to 0.87, P=0.01) and possibly shortened the length of hospital stay (MD= –0.21, 95%CI –0.39 to –0.03, P=0.02) compared with blank control. Currently, no adequate data supported the safety of chewing gum after cesarean section. Conclusion Chewing gum after cesarean section can promote the postoperative bowel recovery, and reduce the odds of postoperative ileus. However, more high quality RCTs are required for lack of included studies and poor quality of methodology.

    Release date:2016-09-07 11:03 Export PDF Favorites Scan
  • Application value of lower abdominal aorta compression in hysterectomy for pernicious placenta previa

    Objective To explore the value of lower abdominal aorta compression in emergent hysterectomy during cesarean section because of pernicious placenta previa. Method We retrospectively analyzed the clinical data of four patients who underwent hysterectomy for pernicious placenta previa with the assistance of lower abdominal aorta compression between January 2016 and March 2017 in Sichuan Provincial Hospital for Women and Children. Result The four patients were cured successfully, and the mothers and babies were all well with no pelvic organ damage or complications related to lower abdominal aorta compression. Conclusions Lower abdominal aorta compression in hysterectomy for pernicious placenta previa during cesarean section is a feasible procedure; it can effectively reduce the amount of bleeding, less affect maternal blood circulation, make surgery area clear, and give the operators the chance to do hysterectomy calmly. Lower abdominal aorta compression presents more and more advantages to treat pernicious placenta previa and may be an effective emergency measure to reduce hemorrhage during perioperative period especially under the circumstances of no chance to carry out vascular intervention treatment.

    Release date:2017-10-27 11:09 Export PDF Favorites Scan
  • 双胎妊娠临床结局分析

    【摘要】 目的 探讨双胎妊娠剖宫产指征构成比、临床处理与妊娠结局的关系。 方法 对2000年1月-2009年8月321例双胎妊娠的临床资料进行回顾分析。 结果 ①A组第1胎儿为头位,191例双胎妊娠剖宫产指征首位为社会因素,其次为妊娠并发(合并)症、瘢痕子宫;B组第1胎儿为非头位,65例双胎妊娠剖宫产指征首位为单纯臀位因素(包括肩先露),其次为妊娠并发(合并)症、瘢痕子宫。②平均分娩孕周(36±4)周,剖宫产256例占79.75%, 经阴道分娩65例占20.25%。③剖宫产组新生儿体重≥2 500 g者高于阴道分娩组;两组第1胎儿新生儿窒息率比较无差异,第2胎儿经阴道分娩者新生儿窒息率明显高于剖宫产术者。校正孕周影响后,不同分娩方式间新生儿评分无差异。④lt;33孕周的双胎妊娠以阴道分娩为主,占83.33%;≥33孕周的双胎妊娠剖宫产率明显高于阴道产率。不同分娩方式的产后出血率无差异。 结论 双胎妊娠不是剖宫产的手术指征,孕期须加强监护管理,正确选择双胎妊娠的分娩方式,将有助于降低剖宫产率及新生儿窒息率。

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • Application of esketamine for postoperative analgesia in cesarean section: a meta-analysis

    Objective To systemically review the clinical application of esketamine for postoperative analgesia in cesarean section. Methods Databases including CNKI, VIP, WanFang Data, PubMed, EMbase, Web of Science, and The Cochrane Library were searched for randomized controlled trials (RCTs) on esketamine in cesarean section from inception to January 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 16 RCTs involving 1 715 cesarean section patients were included. The results of meta-analysis showed that esketamine decreased the patients’ visual analog scale scores after surgery (MD=−0.67, 95%CI −0.86 to −0.49, P<0.000 01) and reduced the need for analgesics for 48 hours after surgery (MD=−2.38, 95%CI −3.15 to −1.62, P<0.000 01) compared with the control drugs (such as opioids, ropivacaine, and normal saline), without increasing adverse reactions such as nausea and vomiting (RR=0.84, 95%CI 0.62 to 1.12, P=0.23), hallucinations (RR=3.00, 95%CI 0.37 to 24.43, P=0.30), drowsiness (RR=1.49, 95%CI 0.16 to 13.99, P=0.73), itching (RR=1.05, 95%CI 0.79 to 1.41, P=0.72), hypotension (RR=0.31, 95%CI 0.04 to 2.40, P=0.26), bradycardia (RR=0.40, 95%CI 0.01 to 11.24, P=0.59), and dizziness (RR=2.24, 95%CI 0.63 to 7.94, P=0.21). Compared with the control drugs, esketamine extended the operation time (MD=2.23, 95%CI 1.73 to 2.74, P<0.000 01), accelerated heart rate (MD=1.31, 95%CI 0.25 to 2.37, P=0.02), and increased the mean arterial pressure (MD=3.88, 95%CI 0.19 to 7.56, P=0.04) during surgery. Additionally, esketamine improved the Apgar score of neonates (MD=0.45, 95%CI 0.26 to 0.63, P<0.000 01) and the Edinburgh postnatal depression scale score of mothers (MD=−1.12, 95%CI −1.87 to −0.55, P=0.000 3), having no effects on the cord blood pH of neonates (MD=0.03, 95%CI −0.01 to 0.07, P=0.14). Conclusion Esketamine has certain advantages when used for postoperative analgesia in cesarean section. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to further verify the above conclusion.

    Release date:2022-07-14 01:12 Export PDF Favorites Scan
  • Clinical Analysis of Central Placenta Previa

    ObjectiveTo explore the related factors for the influences and outcomes of mothers and infants, and further provide a basic reference for reducing maternal and prenatal mortality caused by central placenta previa, through the analysis of its clinical characteristics. MethodsWe retrospectively analyzed the clinical data of 89 patients with central placenta previa treated from January to August 2012. ResultsThere were 89 patients with central placenta previa, and the average age of these patients was (29.6±11.4) years, and the average number of pregnancy among the patients was 3.17. Nine patients had scar uterus; 8 had pernicious placenta previa (9%); 34 had prenatal anemia symptoms; 44 had prenatal vaginal bleeding with the bleeding volume ranged from 2 to 500 mL; 40 were treated before delivery. The average gestational age was 36 weeks ±4.2 days, and 28 of them were readmitted. The intraoperative bleeding in such patients as had placenta located in the anterior wall, placenta adhesion or implantation, history of uterine cavity operation or multipara was more than other patients. The postpartum hemorrhage of patients with the gestational age of 36 weeks or more was more than that of patients with the gestational age shorter than 36 weeks. The incidence of fetal distress in patients with the gestational age of 36 weeks or more is lower and the neonatal 1-minute Apgar score was higher than that in patients with the gestational age shorter than 36 weeks (P<0.05). ConclusionThe treatment of central type of placenta previa should be more active to prolong the gestational week. Patients with placenta adhesion or implantation, caesarean, multipara and placenta in the anterior wall are susceptible to intraoperative bleeding during the termination of pregnancy. Termination of pregnancy in these patients with central placenta previa should be carried out by cesarean section when gestation is more than 36 weeks to reduce postpartum hemorrhage and complications.

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  • 影响剖宫产术后母乳喂养的因素分析及干预措施

    目的 讨论提高剖宫产妇母乳喂养率的方法及途径。 方法 2010年2月-2011年2月,将300例拟择期行剖宫产术的单胎初产妇,按随机抽取法分为观察组和对照组,对其进行母乳喂养宣教及干预,并就术后两组母乳喂养状况进行观察对比。 结果 观察组母乳初动时间早于对照组,两组差异有统计学意义(Z=?6.771,P=0.000);观察组母乳量充足时间早于对照组,两组差异有统计学意义(Z=?4.748,P=0.000)。 结论 术前对产妇进行母乳喂养宣教,术后对产妇母乳喂养给予相关协助与指导是提高母乳喂养的关键。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • Effects of Remifentanly and Ketamin on Parturient Blood Pressure, Heart Rate and Neonate Apgar Score

    目的:对照研究在全麻剖宫产术中应用瑞芬太尼和氯胺酮诱导对母婴的影响。方法:选择100例禁忌椎管内麻醉而须行全麻剖宫产手术的患者,分为两组,氯胺酮组静注异丙酚1.5mg/kg+氯胺酮1mg/kg+琥珀胆碱1.5mg/kg;瑞芬太尼组静注异丙酚1.5mg/kg+瑞芬太尼1μg/kg+琥珀胆碱1.5mg/kg诱导插管,胎儿娩出后均静注芬太尼2g/kg、泵注异丙酚3mg/(kg·h)和吸入异氟醚0.5MAC维持麻醉,阿曲库铵维持肌松。结果:瑞芬太尼组插管(切皮)后血压、心率升高幅度显著小于氯胺酮组,两组新生儿1min、5min Apgar评分无明显差异。结论:瑞芬太尼用于产科全麻优于氯胺酮,安全可行。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
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