Abstract:

Objective　To explore the effect of enhanced recovery after surgery (ERAS) for women after cesarean section. Methods　Ninety-two women who underwent cesarean section in Qinling Hospital, Zhengzhou Maternal and Child Health Hospital from April 2022 to June 2024 were selected for the randomized controlled trial, and were divided into a traditional management group and an ERAS group by lottery, with 46 cases in each group. The traditional management group were (27.93±3.76) years old and 37-41 (38.72±1.52) weeks pregnant, and received traditional obstetric postoperative management. The ERAS group were (28.07±3.23) years old and (39.02±1.36) weeks pregnant, and took ERAS. The operation outcomes, early off-bed activity, breastfeeding, uterine recovery, and postoperative complications were compared between the two groups. t test, χ² test, and Fisher exact probability test were used for the statistical analysis. Results　The score of the Visual Analogue Scale and vaginal bleeding volume 24 h after the surgery in the ERAS group were lower than those in the traditional management group (both P<0.05). The first exhaust time and time for first off-bed activity in the ERAS group were shorter than those in the traditional management group (both P<0.05). The rate of departure from bed 24 h after the surgery in the ERAS group was higher than that in the traditional management group [54.35% (25/46) vs. 28.26% (13/46); P<0.05]. The lactation initiation time and uterine recovery time in the ERAS group were shorter than those in the traditional management group (both P<0.05). The lactation adequacy rate and exclusive breastfeeding rate 3 d after delivery in the ERAS group were higher than those in the traditional management group [76.09% (35/46) vs. 52.17% (24/46) and 67.39% (31/46) vs. 43.48% (20/46); both P<0.05]. The incidence rate of postoperative complications in the ERAS group was 2.17% (1/46), and that in the traditional management group 6.52% (3/46), with no statistical difference (P>0.05). Conclusion　ERAS can promote the early off-bed activity of women after cesarean section, increase the breastfeeding rate, promote their uterine recovery, and improve their surgical outcomes, and is safe.

Key words:

Enhanced recovery after surgery, Caesarean section, Breastfeeding

摘要：

目的　探究加速康复外科护理对剖宫产术后产妇的效果。方法　选取2022年4月至2024年6月在郑州市妇幼保健院秦岭院区进行剖宫产分娩的产妇92例进行随机对照试验。采用抽签法将其分为传统管理组和加速康复组，各46例。传统管理组年龄（27.93±3.76）岁，孕周（38.72±1.52）周，给予产科传统术后管理。加速康复组年龄（28.07±3.23）岁，孕周（39.02±1.36）周，给予加速康复外科护理。对比两组手术结局、早期离床活动情况、母乳喂养及子宫复原情况、术后并发症。采用t检验、χ²检验、Fisher确切概率法进行统计分析。结果　加速康复组术后24 h视觉模拟量表评分、术后24 h阴道出血量均低于传统管理组（均P<0.05）。加速康复组首次排气时间、首次离床活动时间均短于传统管理组（均P<0.05）。加速康复组术后24 h离床率高于传统管理组［54.35%（25/46）比28.26%（13/46），P<0.05］。加速康复组泌乳始动时间、子宫复原时间均短于传统管理组（均P<0.05）。加速康复组产后3 d泌乳充足率、纯母乳喂养率均高于传统管理组［76.09%（35/46）比52.17%（24/46）、67.39%（31/46）比43.48%（20/46），均P<0.05］。加速康复组术后并发症发生率2.17%（1/46），传统管理组6.52%（3/46），差异无统计学意义（P>0.05）。结论　加速康复外科护理可促进剖宫产术后产妇早期离床活动，提高母乳喂养率，促进子宫复原，改善手术结局，且安全性良好。

关键词:

加速康复外科, 剖宫产术, 母乳喂养