首次不同剖宫产切口对腹壁、腹腔粘连性及再次剖宫产的影响

Evaluation the influence of different methods of cesarean section for the first time on postoperative abdominal wall and cavity adhesion and repeated cesarean section

目的 :探讨初次剖宫产不同切口对产妇术后腹壁、腹腔粘连性及再次剖宫产的相关影响。方法 :选择2012年06月~2014年06月在我院待产的剖宫产术后再次妊娠产妇160例作为本次研究对象,并根据其首次剖宫产切口的不同,最终分为:新式剖宫产术80例作为观察组,传统子宫下段剖宫产术80例作为对照组。监测比较两组产妇初次剖宫产的疤痕切口分级,盆腹腔粘连情况以及再次剖宫产的手术时间、产后总出血量、住院时间、切皮至胎儿娩出时间以及镇痛药使用占比,并进行统计分析。结果 :观察组的疤痕切口分级明显优于对照组,且差异具有统计学意义;观察组的盆腹腔粘连情况明显优于对照组,且差异具有统计学意义;观察组的手术时间、产后总出血量、住院时间、切皮至胎儿娩出时间以及镇痛药使用占比明显少于对照组,且差异具有统计学意义。结论 :由于切口的不同,新式剖宫产术相对于传统子宫下段剖宫产术,能有效减少产妇腹壁、腹腔的粘连情况以及促进子宫疤痕恢复,并对产妇再次剖宫产影响较小,因此,在临床上,应尽量指导再次剖宫产产妇行新式剖宫产术,以利于母婴健康。

Objective To observe and explore the influence of different methods of cesarean section for the first time on postoperative abdominal wall and cavity adhesion and repeated cesarean section. Methods 120 pregnant women once again after cesarean sectionin in this hospital since June 2012 to June 2014 were selected. According to the different incisions, all pregnant women were divided into two groups: 80 patients as the observation group by the new-style cesarean section, 80 cases as the control group by the traditional lower uterine segment cesarean section. The incision scar classification and the level of abdominal wall, cavity adhesion after the first cesarean section, and the operation time, postpartum blood loss, hospital stay, fetal childbirth time and usage rates of analgesics after the repeated cesarean section were recorded and compared for statistical analysis in the two groups. Results The incision scar classification and the level of abdominal wall, cavity adhesion in the observation group was obviously better than the control group, the difference was statistically significan; the operation time, postpartum blood loss, hospital stay, fetal childbirth time and usage rates of analgesics in the observation group was obviously lower than the control group, the difference was statistically significant. Conclusion Because of the different incision, the new-style cesarean section can effectively reduce postoperative abdominal adhesions and promote the recovery of uterine scar compared with the traditional lower uterine segment cesarean section, while it also has a small influence for the repeated Cesarean Section. Thus in clinic, the medical workers should try to guide the pregnancy pregnant to choose the new-style cesarean section which is more beneficial to maternal and newborn health.