腹壁瘢痕POSAS评分用于再次剖宫产盆腔粘连预测的应用价值

Application value of POSAS score of abdominal wall scar in the prediction of pelvic adhesion after cesarean section

目的研究腹壁瘢痕患者和观察员瘢痕评估量表(POSAS)评分用于再次剖宫产盆腔粘连预测的应用价值。方法选取广东省连州市人民医院于2019年3-8月收治的行再次剖宫产术的孕妇60例,应用POSAS进行评分,并依据分值大小将孕妇分为观察组(评分≥60,n=26)和对照组(评分<60,n=34),比较两组孕妇的手术时间、术中出血量、盆腔粘连发生情况及产后近期并发症发生情况。结果观察组手术时间、术中出血量均明显高于对照组(P<0.01),观察组的盆腔粘连发生率为61.54%,明显高于对照组的29.41%(χ2=6.19,P=0.01),中重度粘连所占比例亦高于对照组(P<0.05),两组并发症发生情况比较差异无统计学意义(P> 0.05)。结论 POSAS评分对于预测再次剖宫产盆腔粘连的发生具有一定效果,且有助于医护人员及时调整治疗措施,可作为术前辅助的检查手段。

Objective To study the application value of POSAS score of abdominal wall scar in prediction of pelvic adhesion after cesarean section.Methods A total of 60 pregnant women who underwent re-cesarean section in our hospital from March to August2019 were selected as the study subjects. Patient and observer scar assessment scale(POSAS) was used to score, and according to the scores, the pregnant women were divided into observation group(score≥60,n= 26) and the control group(score < 60,n= 34). The operation time, intraoperative blood loss, incidence of pelvic adhesions, and recent postnatal complications were compared between the two groups.Results The operation time and intraoperative blood loss in the observation group were significantly higher than those in the control group(P< 0. 01), the incidence of pelvic adhesions in the observation group was 61. 54%, which was significantly higher than the control group(29.41%)(χ2= 6. 19,P= 0. 01), and the proportion of moderate to severe adhesions in the observation group was also higher than that in the control group(P< 0. 05). However, there was no significant difference in the incidence of complications between the two groups(P> 0. 05).Conclusion The POSAS score has a certain effect in predicting the occurrence of pelvic adhesions in re-cesarean section, and helps medical staff to adjust the treatment measures in time. It can be used as an auxiliary examination method before operation. POSAS score has a certain effect in predicting the occurrence of pelvic adhesion after re-cesarean section, and helps medical staff to adjust treatment measures in time, so it can be used as.