疤痕子宫二次剖宫产与非疤痕子宫剖宫产的对比研究

Comparative Study on Secondary Cesarean Section and Cesarean Section of Non-scar Uterus in Scared Uterus

目的主要将疤痕子宫二次剖宫产与非疤痕子宫剖宫产对产妇分娩的影响进行对比。方法随机选取该院妇产科2017年2月—2018年2月期间行剖宫产的患者100例,按照患者的子宫有无疤痕,分为对照组和实验组,各50例。对照组为非疤痕子宫剖宫产的患者,实验组为疤痕子宫二次剖宫产的患者,比较两组患者的子宫破裂情况、胎盘情况、术中出血量、手术时间等。结果实验组先兆子宫破裂发生率8.00%、胎盘黏连发生率10.00%和前置胎盘发生率8.00%明显比对照组多(χ2=4.354,4.778,4.892,P<0.05)。两组发生子宫破裂的情况差异无统计学意义(χ2=1.224,P>0.05);实验组手术中出血量(424.3±320.1)mL、手术所用的时间(62.7±18.1)min明显比对照组患者多,差异有统计学意义(t=4.627,4.591,P<0.05)。结论疤痕子宫二次剖宫产手术的患者与非疤痕子宫剖宫产患者相比,患者出现先兆子宫破裂情况、胎盘异常情况的发生率明显增加,患者在手术过程中的出血量、手术所用的时间也明显增多,加大了产妇在生产过程中的危险性,对产妇的生命安全造成威胁,因此,在临床生产时,应该慎重选择剖宫产手术,尽量自然分娩,以保障产妇生产时的安全性。

Objective To compare the effect of secondary cesarean section of scar uterus and cesarean section of non-marked uterus on maternal delivery. Methods A total of 100 patients undergoing caesarean section from February 2017 to February 2018 in the Department of Obstetrics and Gynecology at the hospital were randomly selected and divided into a control group and an experimental group according to the presence or absence of scars in the uterus. The control group was a non-scarden uterine cesarean section patient. The experimental group was a secondary cesarean section of the scar uterus.The uterine rupture, placenta, intraoperative blood loss, and operation time were compared between the two groups. Results The incidence of threatened uterine rupture in the experimental group was 8.00%, the incidence of placental adhesions was10.00%, and the incidence of placenta previa was 8.00%, which was significantly higher than that of the control group（χ^24.354, 4.778, 4.892, P0.05）. There was no statistically significant difference in uterine rupture between the two groups（χ^21.224, P〈0.05）; the amount of bleeding（424.3±320.1）mL in the experimental group and the time spent in the surgery（62.7±18.1）min were significantly higher than those in the control group. The difference was statistically significant（t =4.627,4.591, P〉0.05）. Conclusion Patients with secondary cesarean section of scared uterus compared with non-scarned uterine cesarean section patients had signs of precursor rupture of the uterus, incidence of placental abnormalities increased significantly, the amount of bleeding during surgery, the use of surgery time has also increased significantly, increasing the risk of maternal birth in the production process, and threatening the safety of the mother＇s life. Therefore, during clinical production, cesarean section surgery should be cautiously chosen to achieve natural childbirth as far as possible to protect the maternal production safety.