首次不同剖宫产方式对切口瘢痕情况和腹壁腹腔粘连及再次剖宫产的影响

Impact of first different cesarean section methods on incision scar,adhesion between abdominal wall and abdominal cavity and cesarean section again

目的探讨首次不同剖宫方式对切口瘢痕情况、腹壁和腹腔粘连及再次剖宫产的影响。方法选取建湖县第三人民医院2016年5月—2017年3月收治的再次行剖宫产手术产妇76例,按照手术方法不同分为对照组与观察组,各38例。对照组予以传统子宫下段剖宫产术,观察组予以新式剖宫产术,比较两组产妇首次剖宫产后瘢痕恢复情况、腹壁和腹腔粘连,再次手术时间、术中出血量及开腹时间。结果观察组患者瘢痕明显、瘢痕中等发生率低于对照组,瘢痕纤细发生率高于对照组(P<0.05)。观察组产妇首次剖宫产后无粘连率高于对照组,轻度粘连、重度粘连粘连率低于对照组(P<0.05)。观察组患者再次剖宫产手术时间、切皮至胎儿娩出时间及住院时间短于对照组,产后出血量少于对照组(P<0.05)。结论首次剖宫产切口为横切口有助于腹壁、腹腔粘连性恢复,对再次剖宫产的影响较小。

Objective To explore the impact of first different cesarean section methods on incision scar,adhesion between abdominal wall and abdominal cavity and cesarean section again.Methods A total of 76 cases of maternal who underwent repeatly cesarean section were selected from May 2016 to March 2017 in the Third People＇ s Hospital of Jianhu County,which were divided into control group and observation group according to different surgery,38 cases in each group.Control group was given traditional lower uterine segment cesarean section,observation group was given new type of cesarean section.The incision scar,adhesion between abdominal wall and abdominal cavity,reoperation time,intraoperative blood loss and laparotomy time were compared between the two groups.Results The observation group of obvious scar rate and medium scar rate were lower than control group,scar slender rate was higher than control group（P〈0.05）.The observation group of none ahesion rate was higher than control group,mild adhesion and severe adhesion rate were lower than control group（P〈0.05）.The observation group of reoperation time,cut skin to fetal childbirth time and length of stay were shorter than control group,intraoperative blood loss was less than control group（P〈0.05）.Conclusion Cesarean section incision for the first time for crosscutting mouth is helpful to the recovery of adhesion between abdominal wall and abdominal cavity,and have less tmpact on the cesarean section again.