Hillan E M
Department of Nursing and Midwifery Studies, University of Glasgow, Scotland.
J Adv Nurs. 1995 Dec;22(6):1035-42. doi: 10.1111/j.1365-2648.1995.tb03102.x.
The current study was designed to determine the postoperative morbidity associated with Caesarean section and to compare the morbidity with the timing of the operation: elective versus emergency Caesarean section; subgroups of women delivered by emergency Caesarean section; women delivered during the first stage of labour versus those delivered during the course of the second stage. A retrospective review was conducted of the obstetric case record and the midwifery notes of all women delivered by Caesarean section over a 1-year period in a university teaching hospital (n = 619). The variables used to measure postoperative morbidity included: wound infection, intrauterine infection, urinary tract infection, chest infection, pyrexia, urinary catherization and postnatal blood transfusion. Only 9.5% of the women had no recorded morbidity in the postnatal period. Women delivered by emergency Caesarean section experienced a greater number of postnatal problems, an increased incidence of febrile morbidity, more blood transfusions in the postnatal period and a higher proportion had a urinary catheter left in situ after surgery. The incidence of wound infection, intrauterine infection and chest infection was higher in the emergency group and this resulted in an increased proportion of the women requiring antibiotic therapy in the postnatal period. The study found that there was considerable postoperative morbidity associated with Caesarean delivery, particularly if the operation was carried out as an emergency procedure.
本研究旨在确定剖宫产术后的发病率,并比较发病率与手术时机的关系:择期剖宫产与急诊剖宫产;急诊剖宫产分娩的女性亚组;第一产程分娩的女性与第二产程分娩的女性。对一所大学教学医院1年内剖宫产分娩的所有女性(n = 619)的产科病例记录和助产记录进行了回顾性研究。用于衡量术后发病率的变量包括:伤口感染、宫内感染、尿路感染、肺部感染、发热、导尿和产后输血。只有9.5%的女性在产后期间没有记录到发病情况。急诊剖宫产分娩的女性产后问题更多,发热发病率增加,产后输血更多,且术后留置导尿管的比例更高。急诊组的伤口感染、宫内感染和肺部感染发生率更高,这导致产后需要抗生素治疗的女性比例增加。研究发现,剖宫产分娩存在相当高的术后发病率,尤其是在急诊手术的情况下。