术中冲洗预防剖宫产术后盆腹腔粘连的临床比较分析

Intraoperative douching to prevent abdominal or pelvic adhesion after cesarean section

目的探讨生理盐水+甲硝唑冲洗在预防剖宫产术后盆腹腔粘连方面的作用。方法选择两次剖宫产都在我院妇产科且初次手术为改良新式剖宫产且资料完整的395例病例,将初次手术关腹前生理盐水+甲硝唑冲洗盆腹腔198例为观察组;未作冲洗的197例为对照组。对再次剖宫产时盆腹腔粘连程度进行对照回顾性分析。结果观察组盆腹腔粘连11例,占5.6%,以轻度粘连为主。无严重盆腹腔粘连。对照组盆腹腔粘连37例,占18.8%;其中轻度粘连33例,占16.8%,重度粘连4例,占2.0%。观察组轻度、重度粘连例数与对照组比较,差异均有统计学意义(P<0.05)。结论改良新式剖宫产术中关腹前用生理盐水+甲硝唑冲洗能减轻术后盆腹腔粘连。

Objective To explore the effects of physiological saline and metronidazole douching on preventing abdominal or pelvic adhesion after cesarean section.Methods To select 395 cases which had the first and second cesarean section whose first operation adopted new modified cesarean section and had complete materials.In the first operation,198 cases as observation group received the normal saline and metronidazole douching,while 197 cases which did not receive it were regarded as control group.A contrastive and retrospective analysis of the degree of the abdominal or pelvic adhesion was conducted after the second operation.Results There are 11 cases of observation group which present abdominal or pelvic adhesion,accounting for 5.6%.There were mainly mild adhesion and no severe adhesion.While there were 37 cases in control group which had abdominal or pelvic adhesion,accounting for 18.8%,and 33 cases（16.8%） had mild adhesion,and 4 cases（2.0%） had severe adhesion.There were statistical significant difference between observation group and control group in light of cases of mild adhesion and severe adhesion（P〈0.05）.Conclusion New modified cesarean section,the intraoperative douching of normal saline and metronidazole can alleviate abdominal or pelvic adhesion after cesarean section.