首次剖宫产行腹壁中线纵切与腹壁横切对术后并发症及再次剖宫产的影响(1)
[摘要] 目的 对首次剖宫产行腹壁中线纵切与腹壁横切对术后并发症及再次剖宫产的影响进行探讨。方法 方便选取2013年1月—2014年8月该院行再次剖宫产术的产妇90例，按照产妇首次剖宫产腹壁切口的不同将产妇分为观察组和对照组。观察组产妇首次剖宫产行腹壁中线纵切口，对照组产妇首次剖宫产行腹壁横切。探讨首次剖宫产切口选择对产妇再次行剖宫产术的影响。结果 观察组产妇术后瘢痕发生率为42.22%，腹腔粘连发生率为17.78%，对照组产妇术后瘢痕发生率为80%，腹腔粘连发生率为46.67%，观察组产妇并发症发生情况显著低于对照组(P<0.05)；观察组产妇再次剖宫产时，包括手术时间、术中出血量在内的各项手术指标均优于对照组 (P<0.05)。 结论 产妇在首次剖宫产时采取腹壁中线纵切的方法，可以有效减少并发症的发生率、提高再次剖宫产的质量和安全性。
[关键词] 首次剖宫产；纵切；横切；影响
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2016)03(c)-0084-02
Effect of Abdominal Midline Longitudinal Section and Abdominal Transection in Treatment of the First Cesarean Section on the Postoperative Complications and Repeat Cesarean Section
LIU Rui-min
Department of Obstetrics and Gynecology， Zhoukou Central Hospital of Henan Province， Zhoukou，Henan Province，466000 China
[Abstract] Objective To discuss the effect of abdominal midline longitudinal section and abdominal transection in treatment of the first cesarean section on the postoperative complications and repeat cesarean section. Methods 90 cases of puerperas receiving the repeat cesarean section in our hospital from January 2013 to August 2014 were selected and divided into two groups according to the different abdominal incisions of puerperas in the first cesarean section， the observation group were given abdominal midline longitudinal section in the first cesarean section， the control group were given abdominal transection in the first cesarean section， the effect of the choice of incision in the first cesarean section on the repeat cesarean section of puerperas was discussed. Results The incidence rates of the postoperative scars and abdominal adhesion were respectively 42.22% and 17.78% in the observation group and 80% and 46.67% in the control group， the occurrence of complications in the observation group was obviously lower than that in the control group， (P<0.05)， the various operative indexes including the operation time and intraoperative blood loss in the observation group were better than those in the control group in the repeat cesarean section， (P<0.05). Conclusion The method of abdominal midline longitudinal section in the first cesarean section can effectively reduce the incidence rate of complications and improve the quality and security of the repeat cesarean section.
[Key words] First cesarean section； Longitudinal section； Transection； Effect
随着医学技术的不断发展进步，剖宫产率逐年上升，成为了高危产妇、胎儿偏大产妇、高龄产妇的主要生产方式，很好的解决了难产、胎儿窘迫、胎位异常等问题[1]。由于剖宫产是有创性手术的一种，因此产妇在术后较容易出现腹腔粘连、瘢痕子宫等并发症，再次妊娠时前置胎盘、胎盘置入、子宫破裂的概率大大增加，严重影响着产妇再次分娩的安全和质量、威胁着产妇和胎儿的生命[2]。以该院2013年1月—2014年8月收治的90例再次行剖宫产术的产妇为观察对象，对比分析了首次剖宫产切口选择对产妇术后并发症以及再次剖宫产的影响，现报道如下。 (刘瑞敏)
[关键词] 首次剖宫产；纵切；横切；影响
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2016)03(c)-0084-02
Effect of Abdominal Midline Longitudinal Section and Abdominal Transection in Treatment of the First Cesarean Section on the Postoperative Complications and Repeat Cesarean Section
LIU Rui-min
Department of Obstetrics and Gynecology， Zhoukou Central Hospital of Henan Province， Zhoukou，Henan Province，466000 China
[Abstract] Objective To discuss the effect of abdominal midline longitudinal section and abdominal transection in treatment of the first cesarean section on the postoperative complications and repeat cesarean section. Methods 90 cases of puerperas receiving the repeat cesarean section in our hospital from January 2013 to August 2014 were selected and divided into two groups according to the different abdominal incisions of puerperas in the first cesarean section， the observation group were given abdominal midline longitudinal section in the first cesarean section， the control group were given abdominal transection in the first cesarean section， the effect of the choice of incision in the first cesarean section on the repeat cesarean section of puerperas was discussed. Results The incidence rates of the postoperative scars and abdominal adhesion were respectively 42.22% and 17.78% in the observation group and 80% and 46.67% in the control group， the occurrence of complications in the observation group was obviously lower than that in the control group， (P<0.05)， the various operative indexes including the operation time and intraoperative blood loss in the observation group were better than those in the control group in the repeat cesarean section， (P<0.05). Conclusion The method of abdominal midline longitudinal section in the first cesarean section can effectively reduce the incidence rate of complications and improve the quality and security of the repeat cesarean section.
[Key words] First cesarean section； Longitudinal section； Transection； Effect
随着医学技术的不断发展进步，剖宫产率逐年上升，成为了高危产妇、胎儿偏大产妇、高龄产妇的主要生产方式，很好的解决了难产、胎儿窘迫、胎位异常等问题[1]。由于剖宫产是有创性手术的一种，因此产妇在术后较容易出现腹腔粘连、瘢痕子宫等并发症，再次妊娠时前置胎盘、胎盘置入、子宫破裂的概率大大增加，严重影响着产妇再次分娩的安全和质量、威胁着产妇和胎儿的生命[2]。以该院2013年1月—2014年8月收治的90例再次行剖宫产术的产妇为观察对象，对比分析了首次剖宫产切口选择对产妇术后并发症以及再次剖宫产的影响，现报道如下。 (刘瑞敏)