剖宫产术切口愈合不良的危险因素及临床特征分析  

Poor incision healing following cesarean section: risk factors and clinical features

作　　者：张小平[1] 朱艳宾[1] 杨敬一[1] 

机构地区：[1]广东医学院附属南山医院产科,广东深圳518052

出　　处：《社区医学杂志》2014年第10期3-5,共3页Journal Of Community Medicine

摘　　要：目的探讨剖宫产切口愈合不良的发生率及相关危险因素、临床特征、处理及预防措施。方法2007年1月-2012年9月住院剖宫产共9564例，切口愈合不良45例，占0．47％，其中出院后7—10d出现切口愈合不良返院治疗5例，占11．11％。分别为切口脂肪液化12例，切口感染29例，裂开4例。根据患者切口愈合情况将切口愈合不良45例患者作为观察组，随机抽取100例愈合良好者作为对照组。回顾性分析剖宫产产妇的临床资料。计数资料应用Х^2检验，P〈0．05为差异有统计学意义。结果发生切口愈合不良45例，发生率为0．47％；分别为脂肪液化12例、切口感染29例、裂开4例。经抗感染、清创、充分引流、二期缝合等治疗后均愈合。愈合不良的相关因素：肥胖、术前感染、术前贫血、胎膜早破、未预防应用抗生素、阴道检查过多等。结论多种危险因素影响切口的愈合，应积极处理孕前期、孕期及围术期的各个环节，减少剖宫产术后切口感染。Objective To discuss the incidence of poor incision healing following cesarean section and its risk factors, clinical features, management and preventive measures. Methods There were 9,564 cases receiving cesarean section from Jan. 2007 to Sep. 2012, and 45 cases （0.47%）developed poor incision healing,5 cases （11.11% ） had to return to the hospital 7 - 10 d after discharge as a result. Fat liquefaction of incisions occurred in 12 cases, wound infection in 29 cases, and dehiscence in 4 cases. 45 cases of poor incision healing were selected as observation group, 100 cases of well healing were randomly selected as control group. The clinical data on women undergoing cesarean section were retrospectively analyzed. Х^2 test was used for count data, the result of P 〈 0. 05 was considered statistically significant. Results Poor incision healing occurred in 45 cases （0. 47% ）, of which, fat liquefaction occurred in 12cases, infection in 29cases, dehiscence in 4 cases. After anti -inflammatory therapy, debridement, adequate drainage andsecondary suture, all 45 cases got healed. The factors associated with an increased risk of poor incision healing included obesity, preoperative infection, preoperative anemia, premature rupture of membranes, lack of prophylactic antibiotics and excessive vaginal examinations. Conclusions There are multiple risk factors affecting wound healing, therefore, active management should be applied through the period of whole pregnancy to reduce the occurrence of wound infection after cesarean section.

关 键 词：剖宫产 切口愈合不良 危险因素 预防措施 

分 类 号：R719[医药卫生—妇产科学]