前壁前置胎盘剖宫产术子宫自由切口的应用分析

Application of free uterine incision in caesarean section with placenta previa

目的探讨前壁前置胎盘剖宫产术中自由子宫切口的应用效果。方法选取2017年1月—2020年12月96例前壁前置胎盘患者,均采用剖宫产进行分娩,数字随机抽取分成观察组(n=48)和对照组(n=48),对照组采取传统切口,观察组采取自由切口,多数为J形或者反J型子宫切口,比较2组产妇围术期结局、新生儿结局。结果观察组术中出血量少于对照组,胎儿娩出时间短于对照组,差异有统计学意义(P<0.05);2组手术时间、术后排气时间对比差异无统计学意义(P>0.05);观察组发热发生率低于对照组,术后转ICU、输血率低于对照组,差异有统计学意义(P<0.05);2组伤口感染发生率对比差异无统计学意义(P>0.05);观察组新生儿1min Apgar评分、出生时血红蛋白高于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);2组新生儿出生体重、羊水量、5 min Apgar评分对比差异无统计学意义(P>0.05)。结论前壁前置胎盘在剖宫产术时采用J形或者反J型子宫自由切口,可改善产妇、新生儿结局,应用价值高。

Objective To investigate the effect of free uterine incision in caesarean section with placenta previa.Methods A total of 96 patients with anterior wall placenta previa from January 2017 to December 2020 were randomly divided into observation group(n=48)and control group(n=48).The control group received traditional incision,and the observation group received free incision,mostly j-shaped or reverse J-shaped uterine incision.Perioperative outcomes and neonatal outcomes were compared between the two groups.Results The amount of intraoperative blood loss in the observation group was less than that in the control group,and the time of fetal delivery was shorter than that in the control group,with statistical significance(P<0.05).There was no significant difference in operation time and postoperative exhaust time between the two groups(P>0.05).The incidence of fever in the observation group was lower than that in the control group,and the rate of postoperative ICU?transfer and blood transfusion was lower than that in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of wound infection between the two groups(P>0.05).The apgar score at 1min and hemoglobin at birth in the observation group were higher than those in the control group,and the hospitalization time was shorter than that in the control group,with statistical significance(P<0.05).There were no significant differences in birth weight,amniotic fluid volume and 5minApgar score between the two gronps(P>0.05).Conclusion The j-shaped or reverse J-shaped free incision of placenta previa in cesarean section can improve the outcome of puerpera and newborn,and has high application value.