腹壁切口对再次剖宫产手术的影响

Effects on Second Cesarean Section with Abdominal Incision

目的：探讨腹壁横、竖切口对再次剖宫产术的影响。方法：将80例二次剖宫产产妇按前次手术切口方向分为A、B两组，比较横、竖两种腹壁切口再次手术时腹壁及盆腔粘连程度、出血量、开腹时间及总手术时间。结果：腹壁竖切口的开腹时间、手术总时间均少于横切口（P〈O．01），出血量亦少于横切口（P〈O．05）；竖切口的粘连发生率低于横切口（P〈O．01）。结论：腹壁横切口对于初次手术的产妇来说有手术时间短、缝合简单、术后恢复快、切口美观等优点，但对于再次手术的产妇来说，腹壁粘连较竖切口重，进腹困难，导致手术时间长，损伤大。所以对有再次妊娠需要的妇女，应尽可能行腹壁竖切口术式。

Objective： To investigate the effects of second cesarean section with transverse and vertical incision of napes. Methods： According to the incision direction of previous operation, 80 cases of second cesarean section was divided into group A and B to compare the degree of abdominal and pelvic adhesions, amount of bleeding, open time and total operation time of second cesarean section with transverse and vertical incision of napes. Results： Open time and total operation time of abdominal vertical incision was both less than that of transverse incision （P〈0.01）, as well as amount of bleeding （P〈0.05）; the incidence of adhesion of vertical incision was lower than that of transverse incision （P〈0.01）. Conclusion： Abdominal transverse incision has the advantages of short operation time, easy suture, postoperative recovery soon, beautiful incision for puerperae with first section, but it is difficult to operate with severe abdominal adhesion, which results in long operation time and serious injury for puerperae with second sec tion. Therefore, all the second pregnancy women in need should adopt abdominal vertical incision as far as possible.