剖宫产次数及术式与母体并发症的关系  

Correlation of the times of cesarean section and operation method with maternal complications

作　　者：陆铭娜 陈安儿[1] 李洁[1] LU Ming-na;CHEN An-er;LI Jie(Department of Obstetrics,Ningbo Women and Children＇s Hospital,Zhejiang Ningbo 315012,China)

机构地区：[1]宁波市妇女儿童医院产科,浙江宁波315012

出　　处：《中国妇幼健康研究》2018年第9期1164-1167,共4页Chinese Journal of Woman and Child Health Research

基　　金：浙江省医药科技计划资助项目(编号:2018KY715)

摘　　要：目的分析剖宫产次数及术式与术中并发症的关系。方法选取2016年1至12月宁波市妇女儿童医院产科同期收治的初次剖宫产患者252例,二次剖宫产患者1 517例,三次剖宫产患者76例为研究对象,比较三组患者术中并发症的发生情况,并分析二次剖宫产病例中腹壁横切口与竖切口术中并发症发生情况。结果在三组病例中,产后出血量有显著性差异(F=1.412,P<0.05),并随着剖宫产次数增加而增加。产后出血、盆腔粘连、前置胎盘的发生率有显著性差异(χ2值分别为9.541、129.332、7.390,均P<0.05),也随着剖宫产次数增加而增加。二次剖宫产腹壁横切口较竖切口相比,术中胎儿娩出时间、手术总时间更长(t值分别为12.701、8.101,均P<0.05),产后出血比例及膀胱损伤发生率更高,均有统计学差异(χ2=5.756,均P<0.05)。结论剖宫产次数与母体并发症呈正相关性,尤其是盆腔粘连、前置胎盘及产后出血。再次剖宫产腹壁竖切口较横切口能更迅速娩出胎儿,缩短手术时间,降低产后出血及膀胱损伤发生率。Objective To analyze the correlation of the times of cesarean section（CS）and operation method with maternal complications.Methods In this study 252 cases of first CS,1 517 cases of second CS,and 76 cases of third CS were selected in the same period from January to December 2016 in Ningbo Women and Children＇s Hospital.The incidence of maternal complications in three groups was compared.The complications of abdominal wall transverse incision and vertical incision were compared in the case of second CS.Results Bleeding volume after delivery was significantly different among three groups（F=1.412,P〈0.05）,and it increased with the increase of CS times.The incidences of postpartum hemorrhage,pelvic adhesion and placenta previa were significantly different（χ2 value was 9.541,129.332 and 7.390,respectively,all P〈0.05）,and they increased with the times of CS.Compared to cases with vertical incision,cases with abdominal transverse incision had longer fetal delivery time and total operation time（t value was 12.701 and 8.101,respectively,both P〈0.05）and higher rate of postpartum hemorrhage as well as higher incidence of bladder injury（χ2=5.756,both P〈0.05）.Conclusion There is a positive correlation between the times of CS and maternal complications,especially pelvic adhesions,placenta previa and postpartum hemorrhage.Fetus can be delivered more quickly in CS with vertical incision than in CS with transverse incision,and CS with vertical incision can shorten operation time,reduce the incidence of postpartum hemorrhage and bladder injury.

关 键 词：剖宫产 母体并发症病率 产后出血 盆腔粘连 

分 类 号：R714.1[医药卫生—妇产科学]