探讨孕妇在孕期行非产科手术时麻醉方式、手术因素及患者是否存在感染对母胎的影响。

回顾性分析广州医科大学附属第三医院2015年1月至2018年8月收治的87例因非产科疾病行手术治疗孕妇的临床资料，分析患者疾病分类、最终分娩孕周、分娩方式、早产及流产率等妊娠结局，比较不同孕期、不同手术方式、麻醉方式及感染并发症对妊娠结局的影响。

87例患者疾病分类：急性阑尾炎35例(40.2%)，宫内妊娠合并宫外孕7例(8.1%)，卵巢囊肿蒂扭转9例(10.3%)，卵巢肿物21例(24.1%)，泌尿系结石13例(14.9%)，胆囊结石2例(2.3%)；不同孕期接受非产科手术孕妇妊娠结局比较，差异无统计学意义(P>0.05)；不同手术方式孕妇的分娩孕周、分娩方式、流产率、早产率等方面比较，差异无统计学意义(P>0.05)；椎管内麻醉及全身麻醉在分娩方式、分娩孕周、早产及流产等方面比较，差异无统计学意义(P>0.05)。孕妇合并感染对妊娠结局有影响，孕妇合并感染情况对妊娠结局有影响，感染组分娩孕周低于对照组[(34.7±0.7)周与(38.5±0.2)周，Z＝5.088，P<0.05]。感染组剖宫产率、早产率和流产率均高于对照组[41.7% (10/24)与31.7% (20/63), χ²＝7.585；50% (12/24)与7.9% (5/63), χ²＝19.588；50.0% (12/24)与0, χ²＝29.659；P值均<0.05]。

孕期行非产科手术仍然可以获得较满意的妊娠结局，对于病情稳定的患者，不同孕期进行手术、不同麻醉方式和不同手术方式对妊娠结局影响没有差别，但对于合并感染的患者，病情本身的进展可能会影响妊娠结局。

To investigate anesthesia methods, operation factors and infection factors effect on maternal and fetal outcome during non-obstetric surgery.

The clinical data of 87 pregnant women who needed surgical treatments for non-obstetric diseases from January 2015 to August 2018 in The Third Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. We documented their pregnancy outcome indexes such as gestational week, mode of delivery and premature birth rate. Then, the effects of different pregnancies, surgical methods, anesthetic methods and complications of infection on pregnant women′s were compared.

There are 35 cases of acute appendicitis (40.2%), 7 cases of uterine pregnancy complicated with ectopic pregnancy (8.1%), 9 cases of ovarian cyst pedicle torsion (10.3%), 21 cases of ovarian mass (24.1%), 13 cases of Urinary calculi (14.9%) and 2 cases of cholecystolithiasis (2.3%). There were no significant differences in pregnancy outcome among pregnant women undergoing non-obstetric surgery during different pregnancies (P>0.05). There were no significant differences in mode of delivery, gestational age, abortion rate and premature delivery rate between laparoscopy group and abdomen group (P>0.05). There were no significant differences in mode of delivery, gestational age, premature delivery rate and abortion rate between intravertebral anesthesia group and general anesthesia group (P>0.05). The pregnant women with infection had an effect on the pregnancy outcome. The gestational age of the infected group was lower than that of the control group [(34.7±0.7) weeks vs (38.5±0.2) weeks, Z=5.088, P<0.05]. The incident rate of cesarean section, premature delivery and abortion in the infection group were all higher than those in the control group [41.7% (10/24) vs 31.7% (20/63), χ²=7.585; 50% (12/24) vs 7.9% (5/63), χ²=19.588; 50.0% (12/24) vs 0, χ²=29.659; all P<0.05].

Non-obstetric surgery during pregnancy still can achieve satisfactory pregnancy outcome in the stable patients, while different kind of anesthesia and operation in different gestation will not affect the safety of the puerperant and fetus, but the progress of the disease itself may affect the pregnancy outcome for the co-infection patient.