190例二次剖宫产临床分析

Clinical analysis of 190 cases with two cesarean sections

目的:探讨初次剖宫产对二次剖宫产形成的各种影响。方法:对190例二次剖宫产(研究组)和200例首次剖宫产病例(对照组)资料进行回顾分析,两组均采取子宫下段横切口,研究组切除原手术疤痕进腹,对照组取下腹部横切口,比较两组手术开始至胎儿娩出时间(T1)、手术总时间(T2)、术中粘连情况及术中出血情况。结果:二次剖宫产组因不同程度的粘连引起的T1、T2均明显长于首次剖宫产组(P<0.05),术中出血发生率及术中粘连率均高于首次剖宫产组(P<0.05)。结论:应严格掌握剖宫产指征,尽量降低剖宫产率。

Objective： To explore the influence of the first cesarean section on the second section. Methods： Retrospective analysis was made on 190 cases with two cesarean sections （observation group） and the 200 cases with only one cesarean section （control group） in our hospital. Low uterine crosscuttings were carried on both groups. Surgical scar were inside the abdominal in observation group. Low abdominal crosscuttings were carried on control group. The delivered operative time （T1）, the total procedure time （T2）, adhesions and intraoperative bleeding of the two groups were compared. Results：Compared with the control group, T1, T2 in the observation group were all significantly longer due to the abdominal adhesion （P〈0.05）. The intraoperative bleeding rate and the abdominal adhesion rate were significantly higher than that of the control group （P〈0.05）. Conclusions：The indications of cesarean section should be strict ly controlled, to minimize the rate of cesarean section.