改良新式剖宫产术506例临床分析

Improved New Surgical Techniques for Cesarean Section:A Reporter of 506 Cases

目的探讨改良新式剖宫产与新式剖宫产手术优势及再次手术的腹壁及腹腔粘连情况,以期选择最合理的术式,更好地减少或减轻并发症。方法对2003年1月-2010年10月期间,枣庄市立医院行改良新式剖宫产术506例,新式剖宫产术360例,以及二次开腹手术(包括上次改良新式剖宫产78例、上次剖宫产术56例)进行回顾性研究分析,比较两组手术进腹时间、切皮至胎儿娩出时间、手术总时间、进腹出血量、手术出血量,以及术后排气时间、术后疼痛时间、首次下床活动时间、住院时间,同时比较两组手术在再次开服手术时腹壁及盆腔粘连情况。结果改良新式剖宫产手术时间短,术中出血量少,术后病率低,粘连较轻,粘连发生率低,与新式剖宫产术比较其差异具有统计学意义(P<0.05)。结论改良新式剖宫产术步骤简单,粘连较轻,发病率低,值得临床推广应用。

Objective To investigate the advantages of the new surgical techniques for cesarean section and improved new surgical techniques for cesarean section and the occurrence of celiac adhesion in reoperation,so as to choose the most reasonable operation,and reduce complications.Methods A retrospective study was conducted about the improved new surgical techniques for cesarean section in 506 cases,new surgical techniques for cesarean section in 360 cases,and second open surgery（including the last time improved new cesarean section 78 cases,the last time new cesarean section 56 patients） from January 2003 to October 2010.The open time,time from skin incision to delivery,total operation time,blood lose in open and all operation,postoperative time of anal exsufflation and duration of pain,time in bed and hospital stays were compared.And the abdominal wall adhesions and pelvic adhesions in the second operations were compared between the two groups.Results The improved new surgical techniques for cesarean section was with the advantages of short operative time,less blood loss,lower rate of complications,low incidence and lighter adhesion.As compared to the new surgical techniques for cesarean section,the difference was statistically significant（P0.05）.Conclusion The improved new surgical techniques for cesarean section with the simple steps,lighter adhesion and low incidence,is deserved to spread in clinical application.