首次不同剖宫产方式对产妇术后腹腔、腹壁粘连性和再次剖宫产的影响

The effect of different methods of cesarean section for the first time on the adhesion of abdominal cavity, abdominal wall and the second cesarean section

目的探讨首次不同剖宫产方式对产妇术后腹腔、腹壁粘连性以及再次剖宫产的影响。方法将我院自2013年2月至2016年2月收治的再次行子宫下段横切剖宫产产妇986例作为研究对象。根据产妇首次剖宫产选择腹壁切口方式的不同分为两组,其中A组469例产妇初次选择腹壁中线纵切行剖宫产,B组517例产妇初次选择腹壁横切剖宫产,观察并记录两组产妇腹腔、腹壁粘连情况和再次剖宫产术中的情况。结果 A组产妇腹壁瘢痕情况和盆腹腔粘连情况明显优于B组产妇(P<0.05),A组产妇手术总时间、开腹至取出胎儿时间和术中出血量等各项指标均优于B组产妇(P<0.05)。结论首次剖宫产时选择腹壁中线纵切口术式能够有效减轻产妇局部瘢痕程度和盆腹腔粘连程度,缩短手术时间,减少术中出血量,可推广使用。

Objective To investigate the effect of different methods of cesarean section for the first time on the adhesion of abdominal cavity, abdominal wall and the second cesarean section. Methods Nine hundred and eighty-six cases of puerpera women for the second time with lower uterine segment cesarean section from February 2013 to February 2016 in our hospital were selected as research objects. According to the first time abdominal incision for cesarean section, the puerpera women were divided into two groups. Group A （469 cases） received abdominal midline longitudinal cesarean section for the first time, while group B （517 cases） was given abdominal transverse cesarean section for the first time. The adhesion of abdominal cavity, abdominal wall and the second cesarean section situation were compared. Results Maternal abdominal scar and pelvic cavity adhesions in group A were significantly better than those of group B （P〈0.05）, the total time of operation, the time of laparotomy to take out the fetal and the amount of bleeding during the operation were significantly better than those of group B （P〈0.05）. Conclusion Abdominal midline longitudinal cesarean section for the first time can effectively reduce the degree of local scar and pelvic cavity adhesion, shorten the operation time and the amount of bleeding during the second time operation, which can be used and popularized.