剖宫产术中子宫切口撕裂伤的相关因素研究

Study on the related factors of uterine incision laceration during cesarean section

目的：探讨剖宫产术中子宫切口撕裂伤发生的相关因素以便采取有针对性的预防措施。方法：调查、收集2012年6月～2013年6月住院实施剖宫产分娩的孕妇病例资料，以出现子宫切口撕裂伤的孕妇为损伤组，随机选取未出现手术损伤的孕妇为对照组，运用r检验和Logistic回归统计分析方法对相关因素进行分析。结果：与子宫切口撕裂伤相关的因素有胎位、胎头枕位、宫口开大情况及胎儿体重，与是否有盆腔手术史、孕妇年龄、先露高低、产程时间及麻醉效果则无统计学意义（P〉0．05）。枕前位子宫切口撕裂伤发生率最低，巨大儿更容易导致子宫切口撕伤。结论：产前控制胎儿体重、产时及时纠正胎位不正及胎头枕位、减少第二产程剖宫产可以减少剖宫产术子宫切口撕裂伤的发生。

Objective： To explore the related factors of uterine incision laceration during cesarean section in order to adopt targe- ting preventive measures. Methods： The data of pregnant women receiving cesarean section in the hospital from June 2012 to June 2013 were surveyed and collected, the pregnant women with uterine incision laceration were designed as injury group, the pregnant women without uterine incision laceration were selected randomly and designed as control group; X2 test and logistic regression analysis were used to analyze the related factors. Results： The related factors of uterine incision laceration included fetal position, position of fetal occiput, open of cer- vix, and fetal weight; uterine incision laceration was not correlated with surgical history of pelvic cavity, maternal age, location of the presen- tation, duration time of stages of labor, and anesthetic effect （P 〉 0.05 ） ; the incidence rate of uterine incision laceration in occiput anterior presentation was the lowest, uterine incision laceration easily occurred in macrosomia. Conclusion： In order to reduce the incidence rate of uterine incision laceration, the prenatal fetal weight should be controlled, malposition and position of fetal occiput should be corrected timely, cesarean section should be conducted during the second trimester of pregnancy.