不同手术方式对疤痕子宫再次妊娠分娩产妇术后并发症及新生儿结局的影响

Effects of different operative methods on postoperative complications and neonatal outcomes during the delivery of subsequent pregnancy women with scarred uterus

目的探讨两种不同手术方式对疤痕子宫再次妊娠分娩产妇术后并发症及新生儿结局的影响。方法 180例符合入选标准的疤痕子宫再次妊娠分娩产妇按手术方式分为对照组和观察组各90例。对照组行传统子宫下段剖宫产术,观察组行改良周氏子宫下段剖宫产术,观察比较两组手术情况、术后并发症发生率及新生儿结局。结果与对照组相比,观察组手术时间、手术开始至胎儿娩出时间、保留导尿时间、住院时间明显缩短,术中出血量明显减少,比较差异有统计学意义（P〈0.05）。观察组术后并发症的发生率为6.7%,明显低于对照组的27.8%,差异有统计学意义（P〈0.05）。两组均无新生儿死亡,新生儿Apgar评分小于7分和7~10分的比例在两组间比较,差异无统计学意义（P〉0.05）。结论改良周氏子宫下段剖宫产术是疤痕子宫再次剖宫产的一种安全有效术式,优于传统子宫下段剖宫产术。

Objective To investigate the effects of two kinds of operative methods on postoperative complications and neonatal outcomes during the delivery of subsequent pregnan cy women with scarred uterus.Methods A total of 180 subsequent pregnancy women with scarred uterus meeting the inclusion criteria were divided into control group and and observ ation group according to operative methods,each group with 90 women.Women in the control group were treated with traditional low segment cesarean section,and women in the observation group were treated with modified Zhou′s low segment cesarean section.Then the operative situation,the occurrence rate of postoperative complications and neonatal outcomes were observed and compared.Results Compared with the control group,the operation time,time from the beginning of the operation to fetal delivery,catheter-remaining time and hospitalization time in the observation group was statistical shorter,and volume of bleeding during the operation was statistical less（P〈0.05）.The occurrence rate of postoperative complications in the observation group was 6.7% ,which was statistical lower than 27.8% in the control group（P〈0.05）.In the two groups,there′s no case of neonatal death,and the cases with neonatal Apgar sore less than 7 points or 7-10 scores in the two groups had no significant different（P〉0.05）.Conclusion Modified Zhou′s low segment cesarean section is a safety and effective operative method for the delivery of subsequent pregnancy women with scarred uterus,which has many advantages over traditional low segment cesarean secti on.