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目的探讨剖宫产术及阴式分娩对新生儿呼吸困难的影响,为临床选择分娩方式及预防新生儿呼吸困难提供依据。方法选取2015年1月-2016年1月于单县东大医院妇产科分娩的70例新生儿作为研究对象,根据分娩方式不同分为择期剖宫产组及阴式分娩组,每组各35例。比较分析两组新生儿呼吸困难发生率、Apgar评分及血气分析结果。结果择期剖宫产组新生儿呼吸困难发生率为22.86%,显著高于阴式分娩组(14.29%),差异具有统计学意义(t=18.28,P<0.05)。择期剖宫产组新生儿出生后1 min及5 min的Apgar评分分别为(8.56±2.52)分和(9.21±3.12)分,和阴式分娩组相比,差异无统计学意义(均P>0.05)。择期剖宫产组PCO2和碱剩余(BE)负值显著高于阴式分娩组,差异具有统计学意义(t=5.28,P<0.05;t=8.95,P<0.05),而PO2则显著低于阴式分娩组,差异具有统计学意义(t=6.21,P<0.05)。两组HCO3-浓度比较差异无统计学意义(t=1.28,P>0.05)。结论择期剖宫产对Apgar评分无显著影响,但可提高新生儿呼吸困难发生率,同时降低新生儿血液中含氧量,故在临床上应慎重考虑是否行剖宫产术。
Objective To investigate the effect of cesarean section and vaginal delivery on neonatal respiratory distress, and to provide basis for clinical choice of mode of delivery and prevention of neonatal respiratory distress. Methods From January 2015 to January 2016, 70 neonates delivered in Obstetrics and Gynecology Department of Dong County Hospital of Single County were selected as research objects. According to different modes of delivery, patients were divided into elective cesarean section group and vaginal delivery group. 35 cases. The incidence of dyspnea, Apgar score and blood gas analysis were compared between the two groups. Results The incidence of dyspnea in neonates with elective cesarean section was 22.86%, significantly higher than that in vaginal delivery group (14.29%). The difference was statistically significant (t = 18.28, P <0.05). The Apgar scores at 1 minute and 5 minutes after birth in elective cesarean section group were (8.56 ± 2.52) and (9.21 ± 3.12) points, respectively, which were not significantly different from those in vaginal delivery group (all P> 0.05). The negative value of PCO2 and base excess (BE) in elective cesarean section group was significantly higher than that in vaginal delivery group (t = 5.28, P <0.05; t = 8.95, P <0.05), while PO2 was significantly lower In vaginal delivery group, the difference was statistically significant (t = 6.21, P <0.05). There was no significant difference in HCO3- concentration between the two groups (t = 1.28, P> 0.05). Conclusion Elective cesarean section had no significant effect on Apgar score, but it could increase the incidence of dyspnea in neonates and reduce oxygen in the blood of neonates. Therefore, cesarean section should be carefully considered in clinical practice.