不同术式的剖宫产术对再次剖宫产产妇腹腔粘连、盆腔粘连及妊娠结局的影响

目的:探讨不同术式的剖宫产术对再次剖宫产产妇腹腔粘连、盆腔粘连及妊娠结局的影响。方法:选取我院于2007年7月-2017年10月间收治的需再次行剖宫产产妇168例为研究对象。根据首次剖宫产术式分为对照组(新式腹壁横切式)92例和观察组(传统腹壁纵切式)76例。观察并比较两组产妇临床指标,盆腔粘连、腹腔粘连严重程度以及妊娠结局情况。结果:观察组产妇手术时间、胎儿娩出时间、术中出血量、住院时间、肛门排气时间均低于对照组,差异有统计学意义(P0.05)。观察组产妇腹腔粘连发生率为46.05%(35/76),显著低于对照组的77.17%(71/92),差异有统计学意义(P0.05)。观察组产妇盆腔粘连发生率为34.21%(26/76),低于对照组的54.35%(50/92),差异有统计学意义(P0.05)。两组产妇产后出血、术后切口感染、新生儿窒息等发生率比较差异无统计学意义(P0.05)。结论:首次剖宫产术式的选择对再次剖宫产产妇具有较大影响,传统腹壁纵切式可显著改善产妇临床指标情况,减少盆腔粘连、腹腔粘连发生的概率,且术后并发症较少,值得临床推广应用。

Effect of Different Surgical Caesarean Section on Parturients Undergoing Secondary Cesarean Section

ABSTRACT Objective: To investigate the effect of different surgical caesarean section on abdominal adhesion,pelvic adhesion and pregnancy outcome in parturients undergoing secondary cesarean section. Methods: A total of 168 cases of secondary cesarean section, who were admitted to Affiliated Hospital of Zunyi Medical College from July 2007 to October 2017, were selected and were divided into control group (new type transverse abdominal wall, 92 cases) and observation group (traditional abdominal longitudinal type, 76 cases) according to the first cesarean section. The clinical indexes,abdominal adhesion, pelvic adhesion and pregnancy outcome were compared between the two groups of parturients. Results: The operation time,delivery time, amount of bleeding, hospitalization time, anal exhaust time in the observation group were lower than those in the control group (P<0.05). The incidence of abdominal adhesion46.05% (35/76)] in the observation group was significantly lower than that77.17% (71/92)] in the control group, the difference was statistically significant (P<0.05). The incidence of pelvic adhesions34.21% (26/76)] in the observation group was significantly lower than that54.35% (50/92)] in the control group, the difference was statistically significant (P<0.05). There were no significant differences in the incidence of post- partum hemorrhage, postoperative incision infection and neonatal asphyxia between the two groups (P>0.05). Conclusion: The choice of the first cesarean section has a great influence on the second cesarean section; the traditional abdominal longitudinal type can significantly improve maternal clinical indicators, reduce abdominal adhesion rate, with less complication, it is worthy of clinical application.