剖宫产后疤痕子宫人流手术风险分析

Analysis of Risks of Uterine Scar Abortion Surgery after Cesarean Section

目的探讨剖宫产后疤痕子宫的人流手术风险,为提高疤痕子宫人流手术安全性提供指导和参考。方法方便选取2016年1—12月该院收治的206例人流手术患者为研究对象,依据有无剖宫产史将入选病例分为疤痕子宫组(103例)和非疤痕子宫组(103例)。回顾性分析患者临床资料,观察两组流产效果及近期并发症,观察疤痕子宫组术中出血患者与未出血患者的剖宫产时间及孕囊位置。结果疤痕子宫组术中出血率(37.86%)与非疤痕子宫组(19.42%)比较差异有统计学意义(χ2=6.81,P<0.05),妊娠距前次剖宫产不足1年者术中出血率(54.76%)与妊娠距前次剖宫产超过1年者术中出血率(26.23%)比较差异有统计学意义(χ2=8.36,P<0.05),孕囊距子宫瘢痕不足2 cm者术中出血率(65.38%)与孕囊距子宫瘢痕2 cm以上者术中出血率(28.57%)比较差异有统计学意义(χ2=5.41,P<0.05)。结论剖宫产后不足1年妊娠和孕囊距子宫瘢痕不足2 cm的疤痕子宫妊娠人流手术术中出血风险高。

Objective To study the risks of uterine scar abortion surgery after cesarean section thus providing guidance and reference for improving the safety of uterine scar abortion surgery. Methods 206 cases of patients with abortion admitted and treated in our hospital from January to December 2016 were convenient selected as the research objects and divided into two groups with 103 cases in each, and the clinical data were reviewed, and the abortion effect and short-term complications were compared between the two groups, and the cesarean section time and gestational sac site of patients with uterine scar intraoperative bleeding and patients with uterine scar non-intraoperative bleeding were observed. Results The intraoperative bleeding rate in the uterine scar group and in the non-uterine scar group was respectively 37.86% and 19.42%, and the difference was statistically significant（χ^2=6.81,P〈0.05）, and the intraoperative bleeding rate of patients less than 1 year from pregnancy to the cesarean section and patients more than 1 year from pregnancy to the cesarean section was respectively 54.76% and 26.23%（χ^2=8.36,P〈0.05）, and the intraoperative bleeding rate of patients less than 2 cm from gestational sac to uterine scar and patients with more than 2 cm from gestational sac to uterine scar was respectively 65.38% and28.57%, and the difference was statistically significant（χ^2=5.41,P〈0.05）. Conclusion The bleeding risk of uterine scar abortion surgery patients less than 1 year from pregnancy to cesarean section and less than 2 cm from gestational sac to uterine scar is high.