剖宫产中新生儿产伤的临床及相关因素分析

摘要

Objective To review the medical records of neonates found to have birth trauma during cesarean section. Methods 113 cases with birth trauma of 12697 cesarean section were analyzed. Results Risk factors included large for gestational age (LGA) (P = 0. 026) , breech presentation(P = 0. 006) and cesarean section because of failed trial of 1a-bor(P = 0. 021). The most common finding was knife trauma(35%) and Other findings were crush syndrome(29%) and cephalhematoma(21%). Apgar scores were also noted to be lower in birth trauma group(P = 0. 000). Conclusion Risk factors associated with birth injuries during Cesarean Section identified in this study involved large for gestational age, breech presentation and failed trial of labor.improving the skill of delivery is important.%目的 分析剖宫产中新生儿产伤的临床相关因素.方法 回顾性总结剖宫产娩出的12697例新生儿临床资料并对113例产伤的相关因素进行分析.结果 剖宫产中,大于胎龄儿产伤的发生率高于适于胎龄儿及小于胎龄儿(P=0.026)；因试产失败而中转为剖宫产发生产伤的概率高于选择性剖宫产(P=0.021)；臀位剖宫产中产伤的发生率高于非臀位(P=0.006)；剖宫产中新生儿产伤,主要是皮肤刀割伤,其次是头颅血肿和软组织压伤；发生产伤的新生儿,窒息的发生率较高(P=0.000).结论 产伤的高位因素包括体重、臀位、试产失败,因此产前进行详细全面的检查,特别对评估胎儿体重,准确把握剖宫产的指针；同时提高接产者技术水平；新生儿产伤大部分预后良好；对于窒息新生儿,应该仔细查体,警惕合并产伤的发生.