剖宫产术后急性肠梗阻的临床分析

Clinical analysis of 14 cases of intestinal obstruction in the post cesarean section patients

目的探讨剖宫产术后急性肠梗阻的临床相关因素。方法分析北京大学人民医院1990年1月至2010年10月间发生剖宫产术后肠梗阻14例患者的临床资料,并选定患者剖宫产时间同期70例作为对照组,采用巢氏病例对照研究,进行危险因素分析。结果年龄、孕次、产次、孕周、胎儿体重、是否术后镇痛与剖宫产术后肠梗阻无关,产后出血量大于等于800ml和既往腹部手术史是发生剖宫产术后肠梗阻的危险因素。结论对剖宫产术后肠梗阻提高警惕,早期诊断早期处理,产后出血及既往腹部手术史是剖宫产术后肠梗阻的可能危险因素。

Objective To investigate the associated factors of intestinal obstruction in the post cesarean section patients.Methods Records of patients who underwent cesarean section from Jan 1990 to Oct 2010 were analyzed to evaluate the incidence and outcome of intestinal obstruction. The clinical data of 14 cases（0.12%） with intestinal obstruction were carefully analyzed. 70 cases who had no complications were selected into the control group.Results Maternal age,gravidity,parity,gestational week,fetus weight,operation duration,blood loss,postoperative analgesia and history of previous abdominal surgery were not related with intestinal obstruction. Two independent factors were identified：blood loss more than 800 ml,history of previous abdominal surgery.Conclusions Blood loss and history of previous abdominal surgery were two possible independent risk factors of intestinal obstruction in the post cesarean section. Early diagnosis and early treatment are the key issue for these patients.