多次剖宫产术并发症临床分析

Clinical analysis of postoperative complications of repeated cesarean sections

目的探析多次剖宫产术并发症的临床分析。方法选择2013年1月至2014年6月妇产科多次剖宫产术患者50例为观察组,同期选取初次剖宫产术患者50例为对照组,比较两组患者的术后并发症、术中腹腔粘连程度以及多次剖宫产患者不同腹壁切口类型的术后并发症和新生儿情况。结果观察组、对照组的盆腹腔粘连发生率分别为76.0%、2.0%,差异有统计学意义(P<0.01);观察组不全/完全子宫破裂、前置胎盘、胎盘植入/粘连、产后出血、新生儿Apgar评分<7分的发生率显著高于对照组,差异有统计学意义(P<0.01);多次剖宫产纵切口患者的产后出血、子宫破裂、胎盘异常发生率显著低于横切口患者,差异有统计学意义(P<0.05或0.01);纵切口、横切口新生儿Apgar评分<7分的发生率分别为26.9%、37.5%,差异无统计学意义(P>0.05)。结论多次剖宫产术后易出现产后出血、子宫破裂、胎盘异常等并发症,纵切口可降低多次剖宫产术后并发症的发生率,更适于多次剖宫产术。

Objective To investigate postoperative complications of repeated cesarean sections. Methods 50 delivery women who received repeated cesarean sections in Department of Obstetrics and Gynecology from January,2013 to June,2014 were selected as observation group. Meanwhile,50 delivery women who received initial cesarean section during the same period were selected as control group. Then,postoperative complications and degrees of abdominal adhesions during the cesarean sections were compared between groups. In addition,postoperative complications of different incisions of abdominal walls and newborns in the observation group were also compared. Results The incidence rates of abdominal adhesions of the observation group and the control group were 76. 0% and 2. 0%,respectively,so the difference was statistically significant（ P〈 0. 01）; incidence rates of incomplete / complete rupture of uterus,placenta previa,placenta implantation / adhesion,postpartum hemorrhage and Apgar scores（ 7） of the newborns of the observation group were significantly higher than those of the control group,which showed statistically significant difference（ P〈 0. 01）; incidence rates of postpartum hemorrhage,rupture of uterus,placental abnormality of delivery women with repeated cesarean sections by longitudinal incision were significantly lower than those by longitudinal incision,so the difference was statistically significant（ P〈 0. 05 or 0. 01）; incidence rates of Apgar scores（ 7） of the newborns by longitudinal incision and those by transverse incision were 26. 9% and 37. 5%,respectively,so the difference was not statistically significant（ P 〉0. 05）. Conclusion To take the repeated cesarean sections can easily cause postoperative complications such as postpartum hemorrhage,rupture of uterus and placental abnormality. And to take longitudinal incision in the repeated cesarean sections can significantly reduce the incidence rate of postoperative complications,which is more fit for repeated cesarean sections.