剖宫产后再次妊娠不完全性子宫破裂分析  

Analysis of incomplete uterine rupture during pregnancy after cesarean section.

作　　者：李婧 岳亚飞 

机构地区：[1]西安曲江妇产医院,陕西西安710054

出　　处：《中国妇幼健康研究》2012年第4期536-538,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨剖宫产术后再次妊娠不完全性子宫破裂的高危因素。方法回顾分析2011年3至12月期间西安曲江妇产医院的26例瘢痕子宫再次妊娠剖宫产资料，其中不完全性子宫破裂9例，未破裂17例，对前次手术切口愈合情况、切口位置、多次宫腔操作、术前瘢痕厚度及再次妊娠间隔时间等进行比较分析。结果宫腔操作次数、妊娠晚期瘢痕厚度子宫破裂组和未破裂组间比较差异均存在统计学意义（t值分别为2．425、-3．732，均P〈0．05）。结论首次手术后伤口愈合差，多次宫腔操作及瘢痕厚度〈3mm是发生不完全性子宫破裂的高危因素。严格掌握第1次剖宫产指征，提高手术技术，指导避孕，通过辅助手段检测瘢痕状态，是防止子宫不完全性破裂发生的有效预防措施。Objective To explore the high risk factors of incomplete uterine rupture during pregnancy again after cesarean section. Methods Twenty-six cases of scarred uterus who had secondary pregnancy and hospitalized in Xi＇ an Qujiang Obstetric Hospital from March to December 2011 were retrospectively studied, including 9 cases of incomplete uterine rupture and 17 cases of unruptured uterine. SPSS 11.5 was used to analyze the previous surgical incision healing, incision position, uterine cavity operation, thickness of the scar and operation intervals. Results The differences in uterine cavity operation and thickness of the scar at late trimester of pregnancy between two groups were statistically significantly （ t value was 2. 425 and - 3. 732, respectively, both P 〈 0.05 ）. Conclusion Poor wound healing after the first surgery, uterine cavity operation for many times and thickness of the scar 〈 3mm are the high risk factors of incomplete uterine rupture. Strictly mastering the indications of the first cesarean section, improving operation technology, guiding contraception and testing scar state with auxiliary means are the effective measures to prevent the incidence of incomplete uterine rupture.

关 键 词：剖宫产术 瘢痕子宫 不完全性子宫破裂 子宫瘢痕厚度 

分 类 号：R714[医药卫生—妇产科学] R719[医药卫生—临床医学]