剖宫产术后切口愈合不良的高危因素分析

Study of high-risk factors of surgical wound bad healing after cesarean section

目的探讨剖宫产术后切口愈合不良的高危因素,为临床控制切口愈合不良提供依据。方法回顾性调查该院4年间80例孕妇剖宫产术后发生切口愈合不良的相关因素,并根据随机原则,取同期80例切口愈合良好的剖宫产者为对照组。结果在17个影响因素中,阴道检查次数大于或等于2次、肥胖、胎膜早破、前置胎盘、手术时间过长、贫血、低蛋白血症、羊水混浊、前次剖宫产史、妊娠期高血压疾病、妊娠合并糖尿病、产后出血等12项因素在切口愈合不良组和对照组中差异有统计学意义(P<0.05)。在年龄、手术切口方式、妊娠合并血小板减少、妊娠期肝内胆汁淤积症、妊娠合并子宫肌瘤等5项因素中两组差异无统计学意义(P>0.05)。结论针对影响剖宫产切口感染的高危因素如肥胖、贫血、胎膜早破、阴道检查过多等制定有效的预防措施,以减少术后感染的发生。

Objecive To study the high risk factors of surgical wound bad healing after cesarean section. Methods We retro spectively reviewed 80 cesarean section cases with surgical wound bad healing as study group and 80 cesarean section cases with surgical wound good healing as control group. The 17 high risk factors related to the surgical wound bad healing were evaluated. Results Totally 12 factors were identified as the high risk factors such as obesity,anaemia, multiple vaginal examinations,premature rupture of membranes, and prolonged operative time, hypoproteinemia, amniotic fluid turbid, history of cesarean section, hyperten- sive states of pregnancy,diabetes mellitus,placenta previa,postpartum hemorrhage. Those factors showed significant difference between two groups（P〈0.05）. Other 5 factors such as age, surgical mode, thrombocytopenia, pregnancy complicated hysteromyoma and intrahepatic cholestasis of pregaency had no signficant difference between two groups （P〉0.05）. Conclusion We should adopt a measure to those high risk factors for wound healing such as obesity,premature rupture of membranes and frequently vaginal examination for preventing cesarean section wound bad healing.