剖宫产后疤痕子宫人流手术风险分析及防范对策探讨

Analysis of operative risk in scarred uterus induced abortion operation after cesarean section and investigation of prevention measure

目的设计对照试验探讨剖宫产后疤痕子宫人工流产(人流)手术风险及风险防范对策。方法 120例剖宫产后疤痕子宫人流患者(实验组)及120例非疤痕子宫人流患者(对照组)作为研究对象,对比两组患者人流手术过程中不良反发生情况,并探讨手术风险防范对策。结果实验组术后大出血、子宫穿孔、吸宫不全、术后感染等发生率分别为0.83%、1.67%、2.50%、1.67%,对照组分别为0、0.83%、1.67%、1.67%,两组不良反应发生情况比较差异均无统计学意义(P>0.05),且所有出现不良反应患者术后经保守康复疗法治疗后均恢复健康。结论人流手术风险因素与疤痕子宫与否并不具有显著相关性,临床可以通过人流术前B超检查、术前精细的准备工作等降低人流手术风险。

Objective To establish a control experiment for investigation of operative risk in scarred uterus induced abortion operation after cesarean section and risk prevention measure. Methods There were 120 patients receiving scarred uterus induced abortion operation after cesarean section（experimental group） and 120 patients receiving induced abortion operation without scarred uterus（control group） as study subjects. Comparison was made on intraoperative adverse reactions between the two groups. Risk prevention measures were investigated. Results The experimental group had incidences of postoperative massive hemorrhage, perforation of uterus, incomplete uterine aspiration and postoperative infection respectively as 0.83%, 1.67%, 2.50% and 1.67%, which were respectively 0, 0.83%, 1.67% and 1.67% in the control group. There was no statistically significant difference in adverse reactions between the two groups（P〉0.05）. All adverse reactions were relieved by postoperative conservative rehabilitation therapy. Conclusion Risk factor in induced abortion operation shows no remarkable correlation with scarred uterus. Preoperative B ultrasound and detailed preparation can lower risk in induced abortion operation.