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Article(id=1322630885875236864, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.18.019, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1766073600000, receivedDateStr=2025-12-19, revisedDate=1781452800000, revisedDateStr=2026-06-15, acceptedDate=null, acceptedDateStr=null, onlineDate=1793269376486, onlineDateStr=2026-10-29, pubDate=1790265600000, pubDateStr=2026-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793269376486, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793269376486, creator=13701087609, updateTime=1793269376486, updator=13701087609, issue=Issue{id=1322630794611380728, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='18', pageStart='3153', pageEnd='3344', issueExtLink='null', onlineDate='null', pubDate='1790265600000', pubDateStr='2026-09-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1793269354727, creator='13701087609', updateTime=1793343080645, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940023645011984, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940023645011985, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3277, endPage=3281, ext={EN=ArticleExt(id=1322630887464878081, articleId=1322630885875236864, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Effects of pre-pregnancy weight and intrapartum weight on postoperative recovery quality in women undergoing caesarean section, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the effects of pre-pregnancy weight and intrapartum weight on postoperative recovery quality in women undergoing caesarean section.

Methods

A total of 337 women who underwent caesarean section at Jiangsu Shengze Hospital from September 2023 to December 2024 were selected as study subjects.General data of the women were obtained from the hospital's electronic medical record information system.The quality of postoperative recovery was assessed 24 hours after surgery using the Obstetric Quality-of-Recovery(ObsQoR-11) score.

Results

The pre-pregnancy body mass index(BMI) of the 337 women was (23.2±3.3) kg/m2,and the intrapartum BMI was (28.6±3.7) kg/m2.Linear regression analysis showed that the duration of the caesarean section,intrapartum weight,and pre-pregnancy weight were influencing factors for the postoperative recovery quality in women undergoing caesarean section(all P<0.05).

Conclusions

Both intrapartum obesity and pre-pregnancy obesity have a negative impact on the postoperative recovery quality in women undergoing caesarean section. Reasonable weight management should be performed for women undergoing caesarean section to improve the postoperative recovery quality.

, authors=Haoyun SUN, Lai CHENG, Xueqin SHEN, authorsList=Haoyun SUN, Lai CHENG, Xueqin SHEN, authorCompany=null, correspAuthors=Xueqin SHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322630887712342018, articleId=1322630885875236864, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=剖宫产产妇孕前体重和产时体重对术后恢复质量的影响, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

分析剖宫产产妇孕前体重、产时体重对术后恢复质量的影响。

方法

选取于2023年9月—2024年12月在江苏盛泽医院分娩的337例剖宫产产妇作为研究对象，从医院电子病历信息系统获取剖宫产产妇一般资料，于术后24 h采用产科恢复质量评分量表（ObsQoR-11）评分评估剖宫产产妇术后恢复质量。

结果

337例剖宫产产妇孕前体质指数为（23.2±3.3）kg/m2，产时体质指数为（28.6±3.7）kg/m2。线性回归分析结果显示，剖宫产手术时间、产时体重、孕前体重为剖宫产产妇术后恢复质量的影响因素（均P<0.05）。

结论

剖宫产产妇产时肥胖和孕前肥胖对其术后恢复质量具有负面影响，剖宫产产妇应进行合理的体重管理以提高术后恢复质量。

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孙浩云，主管护师，本科

, correspAuthorsNote=
沈雪琴，E-mail:
SHEN Xueqin, E-mail:
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rfNumber=24, rfOrder=23, authorNames=Johnson A J, Peterson J A, Vincent H K, journalName=Front Pain Res(Lausanne), refType=null, unstructuredReference=Johnson A J,Peterson J A,Vincent H K,et al.Body composition and body mass index are independently associated with widespread pain and experimental pain sensitivity in older adults:a pilot investigation[J].Front Pain Res(Lausanne),2024,5:1386573., articleTitle=Body composition and body mass index are independently associated with widespread pain and experimental pain sensitivity in older adults:a pilot investigation, refAbstract=null), Reference(id=1322630893773111359, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, doi=null, pmid=null, pmcid=null, year=2024, volume=48, issue=3, pageStart=370, pageEnd=375, url=null, language=null, rfNumber=25, rfOrder=24, authorNames=Strong A L, Tvina A, Harrison R K, journalName=Int J Obes, refType=null, unstructuredReference=Strong A L,Tvina A,Harrison R K,et al.The association of obesity with post-cesarean inpatient opioid consumption[J].Int J Obes,2024,48(3):370-375., articleTitle=The association of obesity with post-cesarean inpatient opioid consumption, refAbstract=null), Reference(id=1322630893836025920, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=11, pageStart=958, pageEnd=964, url=null, language=null, rfNumber=26, rfOrder=25, authorNames=梁胜男, 郑薇, 宋伟, journalName=北京医学, refType=null, unstructuredReference=梁胜男,郑薇,宋伟,等.不同程度肥胖女性孕期增重与不良妊娠结局的比较研究[J].北京医学,2024,46(11):958-964., articleTitle=不同程度肥胖女性孕期增重与不良妊娠结局的比较研究, refAbstract=null), Reference(id=1322630893903134785, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, doi=null, pmid=null, pmcid=null, year=2000, volume=87, issue=11, pageStart=1480, pageEnd=1493, url=null, language=null, rfNumber=27, rfOrder=26, authorNames=Holte K, Kehlet H, 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tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, xref=1, ext=[AuthorCompanyExt(id=1322630887905280004, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, companyId=1322630887901085699, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Jiangsu Shengze Hospital, Jiangsu 215228 China), AuthorCompanyExt(id=1322630887913668613, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, companyId=1322630887901085699, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1江苏盛泽医院，江苏 215228)])], figs=[ArticleFig(id=1322630890040180771, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, language=EN, label=Table 1, caption=

Univariate analysis of factors influencing postoperative recovery quality in women undergoing caesarean section（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数ObsQoR-11评分统计值P
年龄<35岁27871.9±14.2t=0.9640.336
≥35岁5969.8±15.2
孕周<37周1667.9±10.4t=-1.0270.305
≥37周32171.7±14.5
孕产次1次9870.6±15.5t=-0.7640.445
≥2次23971.9±13.9
剖宫产次数1次15370.4±14.9t=-1.2970.196
≥2次18472.5±13.9
孕前体重低体重组1873.4±17.1
正常体重组18472.8±14.3F=2.9040.035
超重组10470.6±14.3
肥胖组3165.3±12.1
产时体重低体重组00.0
正常体重组3275.9±14.4F=3.8750.022
超重组12973.1±14.9
肥胖组17669.6±13.7
剖宫产手术24 h出血量<1 000 mL32871.7±14.3t=1.3850.176
1 000~<2 000 mL965.0±15.1
剖宫产手术时间<60 min25674.6±13.8t=8.397<0.001
≥60 min8161.7±11.5
新生儿出生时体重<4 000 g30871.7±14.2t=0.8450.399
≥4 000 g2969.4±15.7
), ArticleFig(id=1322630890199564324, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, language=CN, label=表1, caption=

剖宫产产妇术后恢复质量影响因素的单因素分析（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数ObsQoR-11评分统计值P
年龄<35岁27871.9±14.2t=0.9640.336
≥35岁5969.8±15.2
孕周<37周1667.9±10.4t=-1.0270.305
≥37周32171.7±14.5
孕产次1次9870.6±15.5t=-0.7640.445
≥2次23971.9±13.9
剖宫产次数1次15370.4±14.9t=-1.2970.196
≥2次18472.5±13.9
孕前体重低体重组1873.4±17.1
正常体重组18472.8±14.3F=2.9040.035
超重组10470.6±14.3
肥胖组3165.3±12.1
产时体重低体重组00.0
正常体重组3275.9±14.4F=3.8750.022
超重组12973.1±14.9
肥胖组17669.6±13.7
剖宫产手术24 h出血量<1 000 mL32871.7±14.3t=1.3850.176
1 000~<2 000 mL965.0±15.1
剖宫产手术时间<60 min25674.6±13.8t=8.397<0.001
≥60 min8161.7±11.5
新生儿出生时体重<4 000 g30871.7±14.2t=0.8450.399
≥4 000 g2969.4±15.7
), ArticleFig(id=1322630891839537189, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, language=EN, label=Table 2, caption=

Linear regression analysis of factors influencing postoperative recovery quality in women undergoing caesarean section

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数标准误标准化回归系数t值P95%CI
常量89.3922.31238.666<0.001[88.164，101.521]
剖宫产手术时间（≥60 min）-12.8081.680-0.381-7.625<0.001[-16.092，-9.494]
产时体重（肥胖组）-3.7681.437-0.131-2.6220.009[-5.202，-0.926]
孕前体重（肥胖组）-2.5611.113-0.107-1.5900.028[-3.415，-0.517]
), ArticleFig(id=1322630891919228966, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630885875236864, language=CN, label=表2, caption=

剖宫产产妇术后恢复质量影响因素的线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量回归系数标准误标准化回归系数t值P95%CI
常量89.3922.31238.666<0.001[88.164，101.521]
剖宫产手术时间（≥60 min）-12.8081.680-0.381-7.625<0.001[-16.092，-9.494]
产时体重（肥胖组）-3.7681.437-0.131-2.6220.009[-5.202，-0.926]
孕前体重（肥胖组）-2.5611.113-0.107-1.5900.028[-3.415，-0.517]
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剖宫产产妇孕前体重和产时体重对术后恢复质量的影响
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孙浩云 , 程莱 , 沈雪琴 *, *
护理研究 | 综合研究 2026,40(18): 3277-3281
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护理研究 |综合研究 2026 , 40 (18) : 3277 -3281
剖宫产产妇孕前体重和产时体重对术后恢复质量的影响
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孙浩云, 程莱, 沈雪琴*, *
作者信息
  • 1江苏盛泽医院，江苏 215228
通讯作者:
沈雪琴，E-mail:
SHEN Xueqin, E-mail:
作者简介:

孙浩云，主管护师，本科

Effects of pre-pregnancy weight and intrapartum weight on postoperative recovery quality in women undergoing caesarean section
Haoyun SUN, Lai CHENG, Xueqin SHEN
Affiliations
  • 1Jiangsu Shengze Hospital, Jiangsu 215228 China
出版时间: 2026-09-25 doi: 10.12102/j.issn.1009-6493.2026.18.019
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摘要
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目的

分析剖宫产产妇孕前体重、产时体重对术后恢复质量的影响。

方法

选取于2023年9月—2024年12月在江苏盛泽医院分娩的337例剖宫产产妇作为研究对象，从医院电子病历信息系统获取剖宫产产妇一般资料，于术后24 h采用产科恢复质量评分量表（ObsQoR-11）评分评估剖宫产产妇术后恢复质量。

结果

337例剖宫产产妇孕前体质指数为（23.2±3.3）kg/m2，产时体质指数为（28.6±3.7）kg/m2。线性回归分析结果显示，剖宫产手术时间、产时体重、孕前体重为剖宫产产妇术后恢复质量的影响因素（均P<0.05）。

结论

剖宫产产妇产时肥胖和孕前肥胖对其术后恢复质量具有负面影响，剖宫产产妇应进行合理的体重管理以提高术后恢复质量。

剖宫产  /  产妇  /  孕前体重  /  产时体重  /  肥胖  /  术后恢复质量  /  影响因素
Objective

To analyze the effects of pre-pregnancy weight and intrapartum weight on postoperative recovery quality in women undergoing caesarean section.

Methods

A total of 337 women who underwent caesarean section at Jiangsu Shengze Hospital from September 2023 to December 2024 were selected as study subjects.General data of the women were obtained from the hospital's electronic medical record information system.The quality of postoperative recovery was assessed 24 hours after surgery using the Obstetric Quality-of-Recovery(ObsQoR-11) score.

Results

The pre-pregnancy body mass index(BMI) of the 337 women was (23.2±3.3) kg/m2,and the intrapartum BMI was (28.6±3.7) kg/m2.Linear regression analysis showed that the duration of the caesarean section,intrapartum weight,and pre-pregnancy weight were influencing factors for the postoperative recovery quality in women undergoing caesarean section(all P<0.05).

Conclusions

Both intrapartum obesity and pre-pregnancy obesity have a negative impact on the postoperative recovery quality in women undergoing caesarean section. Reasonable weight management should be performed for women undergoing caesarean section to improve the postoperative recovery quality.

caesarean section  /  parturient  /  pre-pregnancy weight  /  intrapartum weight  /  obesity  /  postoperative recovery quality  /  influencing factors
孙浩云, 程莱, 沈雪琴. 剖宫产产妇孕前体重和产时体重对术后恢复质量的影响. 护理研究, 2026 , 40 (18) : 3277 -3281 . DOI: 10.12102/j.issn.1009-6493.2026.18.019
Haoyun SUN, Lai CHENG, Xueqin SHEN. Effects of pre-pregnancy weight and intrapartum weight on postoperative recovery quality in women undergoing caesarean section[J]. Chinese Nursing Research, 2026 , 40 (18) : 3277 -3281 . DOI: 10.12102/j.issn.1009-6493.2026.18.019
正文
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剖宫产术是妇产科最常见的外科手术之一，剖宫产产妇术后恢复质量对恢复其术后身心状态、促进母婴关系、降低治疗费用、改善满意度等具有重要影响[1]，充分评估剖宫产产妇术后恢复质量有利于改善产妇恢复状况[2]。目前，针对剖宫产产妇术后恢复质量的评价方法有限，产科恢复质量评分量表（ObsQoR-11）评分作为专门针对剖宫产产妇术后恢复质量的评分工具[3-4]，已经在剖宫产产妇中得到验证[5-6]。肥胖是全球公共卫生问题之一。已有数据显示，我国成年人超重和肥胖率分别为34.3%和16.4%[7]。孕期超重/肥胖与多种围生期不良母儿并发症相关，且可增高剖宫产发生风险[8]。本研究通过探索剖宫产产妇孕前体重、产时体重等因素与ObsQoR-11评分的相关性，以期为孕期体重管理和剖宫产产妇术后恢复质量的改善提供参考。
1　对象与方法
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1.1　研究对象
选取于2023年9月—2024年12月在江苏盛泽医院分娩的剖宫产产妇作为研究对象。纳入标准：年龄 18~40岁；孕前体重明确；孕36~42周；剖宫产麻醉方式为蛛网膜下腔阻滞与硬膜外腔阻滞相结合，术后采用硬膜外镇痛泵镇痛，术后24 h去除镇痛泵和尿管；由副高级及以上职称医生主持开展手术。排除标准：存在妊娠严重并发症[如转氨酶升高和血小板减少（HELLP）综合征、妊娠期急性脂肪肝、妊娠期急性胰腺炎、前置胎盘、胎盘植入、胎盘早剥、重度产后出血等]，术后需重症监护；妊娠合并严重内外科疾病；无法完成ObsQoR-11评分；双胎或多胎妊娠。样本量估算：根据方程n=t2×p×q/d2计算最小样本量，其中n为所需样本量；t取1.96；p为肥胖发生率，取16.4%[7]；q=1-p；d为误差范围，取0.05。计算得最少应纳入剖宫产产妇211人。本研究已取得剖宫产产妇知情同意,并通过我院医学伦理委员会批准（伦理号：2023-SR-030-01；2023-SR-046-01）。
1.2　数据采集方法
1.2.1　剖宫产产妇一般资料
从医院电子病历信息系统获取剖宫产产妇一般资料，包括年龄、孕周、孕产次、剖宫产次数、孕前体重（早孕建卡时已记录，并于入院时再次核对）、产时体重、剖宫产手术24 h出血量、剖宫产手术时间、新生儿出生时体重等。其中，孕前体重和产时体重组别均基于体质指数（BMI）划分，BMI=体重（kg）/身高平方（m2)，身高使用立柱式身高计测量，测量时要求脱去鞋、帽，足跟、臀部和两肩胛角间3个点同时接触立柱，双眼平视前方，误差控制在0.1 cm以内；体重测量时要求排空大小便、脱鞋、穿单薄衣服，误差控制在0.01 kg以内。参照2021年中国营养学会发布的团体标准[9]，将孕妇孕前体重分为4组，即低体重组（BMI<18.5 kg/m2）、正常体重组（BMI为18.5~<24.0 kg/m2）、超重组（BMI为24.0~<28.0 kg/m2）、肥胖组（BMI≥28.0 kg/m2）。目前尚无产时体重分组标准，为便于研究描述，参考已有研究[10]，通过分娩时近1周的BMI将产时体重分为4组，即低体重组（BMI<18.5 kg/m2）、正常体重组（BMI为18.5~<24.0 kg/m2）、超重组（BMI为24.0~<28.0 kg/m2）、肥胖组（BMI≥28.0 kg/m2）。剖宫产手术24 h出血量包括术中出血量（从手术记录单获取）和返回病房后的出血量（使用称重法获得）。
1.2.2　ObsQoR-11评分
于术后24 h评估。针对问题“你在过去24 h内感觉怎么样？”进行回答，包含11个作答条目，每个条目分为11个等级，其中5个条目（“我痛得影响活动”“我痛得动弹不了”“我有恶心呕吐”“我头昏头晕”“我一直在发抖”）从“强烈赞同”到“非常反对”依次计0~10分，剩余6个条目（“我一直舒适”“我能独立活动”“我能独抱小孩”“我能自己喂小孩”“我自个上厕所”“我能掌控”）反向计分，得分越高说明剖宫产产妇术后恢复质量越好[6]。
1.3　质量控制
参与调查的医务人员均经过统一培训，熟悉剖宫产产妇信息采集方法，掌握ObsQoR-11评分内容和问询方法。调查过程中如剖宫产产妇无法理解评分内容则予以剔除。双人对数据进行电子录入和核对。共发放问卷360份，回收有效问卷337份，问卷有效回收率为93.6%。
1.4　统计学方法
采用SPSS 19.0统计软件对数据进行统计分析。符合正态分布的定量资料以均数±标准差（x±s）表示，两组间比较采用t检验，多组间比较采用单因素方差分析；不符合正态分布的定量资料以中位数（四分位数）[M（P25，P75）]表示，组间比较采用非参数检验；定性资料以频数及百分比（%）表示。采用逐步线性回归分析探讨剖宫产产妇术后恢复质量影响因素。以P<0.05为差异有统计学意义。
2　结果
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2.1　剖宫产产妇术后恢复质量影响因素的单因素分析
337例剖宫产产妇年龄（29.8±5.1）岁，分娩孕周（38.9±1.0）周，产次2（1,2）次，剖宫产次数为2（1,2）次，孕前BMI为（23.2±3.3）kg/m2，产时BMI为（28.6±3.7）kg/m2，剖宫产手术24 h出血量为（540.5±173.1）mL，剖宫产手术时间为（50.5±13.9）min，新生儿出生体重为（3 402.1±428.8）g，ObsQoR-11评分为（71.5±14.2）分。剖宫产产妇术后恢复质量影响因素的单因素分析结果见表1。
2.2　剖宫产产妇术后恢复质量影响因素的线性回归分析
以ObsQoR-11评分为因变量，以单因素分析中差异有统计学意义（P<0.05）的变量为自变量，进行线性回归分析。自变量赋值方式：孕前体重，正常体重组=（0，0，0），低体重组=（1，0，0），超重组=（0，1，0），肥胖组=（0，0，1）；产时体重，正常体重组=（0，0，0），低体重组=（1，0，0），超重组=（0，1，0），肥胖组=（0，0，1）；剖宫产手术时间，<60 min=0，≥60 min=1。线性回归分析结果显示，剖宫产手术时间、产时体重、孕前体重为剖宫产产妇术后恢复质量的影响因素（均P<0.05）。见表2。
3　讨论
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3.1　剖宫产产妇术后恢复质量
剖宫产术是妇产科最常见的手术之一，我国是世界上剖宫产率较高的国家之一[11]，充分评估剖宫产产妇术后恢复质量，对改善产妇恢复情况具有重要意义。然而，目前针对剖宫产产妇术后恢复质量的评价方法有限，40项恢复质量评分（QoR-40）[12]、15项恢复质量评分（QoR-15）[13]、欧洲五维度健康量表（EuroQol-5D）[14]和健康调查简表[15]可用于衡量剖宫产产妇的术后恢复情况，但尚未检索到其在产科特定环境中的验证性研究。ObsQoR-11评分作为专门针对剖宫产产妇术后恢复的评价工具，已在选择性剖宫产产妇[5]和非选择性剖宫产产妇[6]中得到验证，是一种有效、可靠的剖宫产术后恢复评价方法[16-17]，且近年来逐渐被用于剖宫产产妇的术后恢复情况相关研究[18-19]。
3.2　孕前体重、产时体重与剖宫产产妇术后恢复质量的相关性
随着我国经济水平不断提高及生活方式不断改变，超重/肥胖率持续上升，已有研究结果显示，成年居民超重/肥胖率已达一半以上[7]，超重和肥胖孕妇明显增多。目前，关于孕期超重/肥胖与剖宫产产妇术后恢复质量的相关性研究有限，Ciechanowicz等[4]对非择期剖宫产产妇研究后发现，孕前BMI与ObsQoR-11评分无相关性，但该研究未对孕前体重进行分层，因此不同孕前体重状态对剖宫产产妇术后恢复质量是否具有影响尚不清楚。Zimmo等[20]研究发现，Ⅲ度肥胖剖宫产产妇（BMI≥40 kg/m2）术后ObsQoR-11评分与非肥胖剖宫产产妇（BMI<30 kg/m2）比较差异不明显。本研究对剖宫产产妇孕前体重和产时体重进行分层研究，结果显示，孕前肥胖组的ObsQoR-11评分低于孕前正常体重组（P<0.05），产时肥胖组的ObsQoR-11评分低于产时正常体重组（P<0.05），表明孕前肥胖和产时肥胖对剖宫产产妇的术后恢复质量有负面影响。
3.3　剖宫产产妇术后恢复质量影响因素
目前，关于剖宫产产妇术后恢复质量的影响因素研究有限。一项研究对剖宫产产妇术后加速康复情况进行研究发现，孕前肥胖、多次剖宫产可能会增加术后加速康复失败率（如住院时间>5 d、术后尿潴留和肠梗阻等）[21]。本研究发现，产时体重、孕前体重为剖宫产产妇术后恢复质量的影响因素（均P<0.05）。肥胖与炎症、代谢变化以及多种内科和妊娠相关并发症有关。已有研究结果显示，与非肥胖孕妇相比，肥胖孕妇患妊娠期糖尿病、妊娠期高血压疾病、血栓栓塞、产程异常、产后出血、伤口感染和死亡的风险更高，肥胖还与非计划性剖宫产率增加有关[22]，肥胖孕妇剖宫产手术时间较长[23]。肥胖者对疼痛敏感性增加，可能与局部氧化应激和促炎过程增加有关[24]。肥胖相关的变化还会影响镇痛药物的药代动力学和药效学[25]。此外，梁胜男等[26]研究发现，孕前超重/肥胖孕妇在孕期更易出现体重增加过多，可进一步使产时肥胖孕妇增多，加大对剖宫产产妇术后恢复质量的影响，提示应对孕前肥胖人群予以关注。本研究发现，剖宫产手术时间为剖宫产产妇术后恢复质量的影响因素（P<0.05）。剖宫产手术时间延长，术中操作干扰肠管及手术应激等刺激增加，可能导致术后胃肠道功能障碍，术后剖宫产产妇易出现恶心、呕吐、腹胀、腹痛以及排气或排便延迟等情况，进而导致剖宫产产妇术后恢复延迟[27-28]。剖宫产手术时间与多种因素有关，一般而言，剖宫产次数越多手术时间越长。但本研究中，剖宫产次数对剖宫产产妇术后恢复质量的影响不明显，原因可能是本研究中的多次剖宫产产妇剖宫产次数多为2次，与1次剖宫产相比差别不明显，故对手术时间的影响有限，且多次剖宫产产妇具有剖宫产术后护理经验，能更从容地面对剖宫产术后的挑战，从而对剖宫产术后恢复带来帮助。
3.4　研究局限性
1）本研究为单中心研究，样本量相对较小，限制了研究结果的外推性。2）社会经济因素、心理健康、饮食运动和社会支持等混杂变量未被充分考虑，可能影响其交互作用的体现。3）研究指标是在术后24 h收集，效果研究时间较短，未来研究需要评估更长时间剖宫产产妇的恢复情况。
4　小结
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产时肥胖和孕前肥胖对剖宫产产妇术后恢复质量有负面影响。剖宫产产妇孕前应尽早进行体重管理；孕期应进行合理的饮食和运动管理，从而提高剖宫产产妇术后恢复质量。

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doi: 10.12102/j.issn.1009-6493.2026.18.019
  • 接收时间：2025-12-19
  • 首发时间：2026-10-29
  • 出版时间：2026-09-25
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  • 收稿日期：2025-12-19
  • 修回日期：2026-06-15
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    1江苏盛泽医院，江苏 215228

通讯作者:

沈雪琴，E-mail:
SHEN Xueqin, E-mail:
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https://castjournals.cast.org.cn/joweb/hlyj/CN/10.12102/j.issn.1009-6493.2026.18.019
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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