改良子宫切口在入分娩室试产患者剖宫产术中的应用评估

Evaluation of application of modified uterine incision during cesarean section after trial of labor in delivery room

目的：评估改良子宫切口在入分娩室试产患者剖宫产术中的有效性及安全性。方法：选取2013年1月~10月于嘉兴市妇幼保健院住院入分娩室试产后改行剖宫产分娩的113例患者,根据子宫切口不同分为改良子宫切口剖宫产组（55例）和传统子宫下段剖宫产组（58例）。观察并比较两组手术时间、术中出血量、胎儿娩出时间、术后排气时间及术后恢复情况等。同时比较两组新生儿有关临床数据。结果：与传统子宫下段剖宫产组相比,改良子宫切口剖宫产组术中出血量较少、子宫切口延裂率低、手术总时间短、胎儿娩出时间较短且Apgar评分较高（P〈0.05）。两组术后胃肠功能恢复情况比较差异无统计学意义（P〉0.05）。结论：在入分娩室试产患者剖宫产术中,改良子宫切口可显著减少术中出血量、降低子宫切口延裂率,且有利于娩出胎儿,缩短胎儿娩出时间。它提供了一种处理入分娩室试产患者的新剖宫产术式。

Objective： To evaluate the efficacy and safety of modified uterine incision during cesarean section for trial of labor in delivery room. Methods： A total of 113 patients adopting cesarean section after trial of labor in delivery room of this hospital from January to October in 2013 were selected and divided into modified uterine incision group （55 patients） and traditional uterine incision group （58 pa- tients） according to different uterine incisions. The operation time, the amount of blood loss during operation, the delivery time, the postop- erative exhausting time and postoperative recovery in the two groups were observed and compared. The related clinical data were compared between the two groups. Results： Compared with traditional uterine incision group, the amount of blood loss during operation in modified u- terine incision group was fewer, the incidence rate of uterine incision extension was lower, the total operation time was shorter, the delivery time was shorter and Apgar score was higher, there were statistically significant differences （ P 〈 0.05 ） . There was no statistically signifi- cant difference in postoperative recovery of gastrointestinal function between the two groups （ P 〉 0. 05 ） . Conclusion： Modified uterine in- cision during cesarean section after trial of labor in delivery room can significantly reduce the amount of blood loss during operation and the incidence rate of uterine incision extension, which is beneficial to delivery and it can shorten delivery time, modified uterine incision provides a new method for cesarean section after trial of labor in delivery room.