腹壁横切口子宫下段剖宫产术对腹部肌群损伤的临床观察

Observation of the Abdominal Muscle Damage in Lower Uterus Cesarean Section via Transverse Incision on Wall of Abdomen

目的比较腹壁横切口、纵切口子宫下段剖宫产术对腹部肌群的损伤程度。方法观察组300例行腹壁横切口子宫下段剖宫产术,对照组280例行腹壁纵切口子宫下段剖宫产术,两组分别于产后5～7d、产后42d、产后1年通过产妇症状、体征及超声检查了解腹部肌群损伤情况。结果腹壁横切口与纵切口子宫下段剖宫产术腹部肌群的损伤,产后5～7d,腹痛发生率分别为83.0%,5.2%;皮下硬结发生率分别为32.7%,0;超声发现肌肉损伤率分别为83.0%,5.2%。产后42d,腹痛发生率分别为20.9%、0;皮下硬结均未发生,超声发现肌肉损伤率为64.5%,0。两组比较差异有非常显著性意义（P〈0.001）。结论腹壁横切口子宫下段剖宫产术腹部肌群的损伤程度较纵切口为重,手术存在一定缺陷。

Objective To eompare the abdominal muscle damages in lower uterus cesarean sections between transverse and longitudinal incisions. Methods 300 cases belonging to observing group were operated with lower uterus cesarean section via transverse incision on wall of abdomen,while 280 via longitudinal incision as control group.The abdominal muscle damages of the two groups were observed through symptoms,signs and ultrasonic examination in 5-7,42 days and 1 year of the operations.Results The incidence rates of abdominal pain of the two groups were respectively 83.0% and 5.2% 5-7 days later after operation, and that of subcutaneous induration were 32.7% and 0%.The abdominal muscle damage rates found by ultrasonic were respectively 83.0% and 5.2% at the same time.Furthermore,42 days later after operation,the incidence rates of abdominal pain were 20.9% and 0%,and muscle damage rates were 64.5% and 0%,and there was no subcutaneous induration for both of the groups.Significant differences existed between the two groups （P〈0.001）. Conclusion The abdominal muscle damage of transverse incision on the abdomen wall is more severe than that of longitudinal one for lower uterus cesarean section, which stands for a shortcoming.