首次剖腹产切口对二次剖腹产手术的影响  

Influence of first caesarean section incision on second caesarean section operation

作　　者：马敬敬 Ma Jingjing(Department of Obstetrics and gynecology,Fengxian people's hospital,Xuzhou,Jiangsu,221700,China)

机构地区：[1]丰县人民医院妇产科,江苏徐州221700

出　　处：《当代医学》2018年第22期11-14,共4页Contemporary Medicine

摘　　要：目的分析首次剖宫产切口的选择对二次剖宫产的影响。方法选取2015年1月~2017年12月102例二次剖宫产产妇,根据首次剖宫产切口方式,展开分组:腹壁横切口组(H组)43例;腹壁纵切口组(Z组)59例。比较两组产妇的开腹时间、胎儿娩出时间、总手术时间、术中出血量患者术后腹壁粘连程度对比。结果 Z组产妇的开腹时间、胎儿娩出时间、总手术时间、术中出血量均低于H组(P<0.05);Z组、H组患者在新生儿评分、Apgar评分分级、窒息发生率对比差异无统计学意义;Z组27.12%(16/59)的患者发生中重度腹腔粘连,H组48.84%(21/43)的患者发生中重度腹腔粘连,Z组腹腔粘连发生率及严重程度明显低于H组(P<0.05)。结论首次剖宫产切口腹壁纵切口效果显著优于选择腹壁横切口,能够缩短产妇的开腹时间及胎儿娩出时间,减少产妇术中输血量且有助于产妇的二次剖腹产手术实施,临床应用价值相对较高。Objective To explore the effect of the first incision of different caesarean section on two caesarean section.Methods In January 2015-December 2017,102 cases of two cesarean section women were selected.They were divided into transverse incision group(group H),43 cases and longitudinal incision group(group Z)59 cases according to the first cesarean section incision.Compared with two groups,only two cesarean section cases were compared.Results The bleeding in Z group were open time,delivery time,total operative time,intraoperative amount were significantly lower than group H(P<0.05);there was no significant difference in neonatal score,neonatal score,Apgar score,asphyxia between Z group and group H;group Z(27.12%16/59)in patients with mild to moderate abdominal adhesions,48.84%patients of group H(21/43)in patients with mild moderate and severe abdominal adhesion,the adhesion in group Z was significantly lower than the incidence and severity of H group(P<0.05).Conclusion The first cesarean section is more helpful to optimize the index of two caesarean section and reduce the incidence of abdominal adhesion.

关 键 词：首次剖腹产 腹壁横切口 腹壁纵切口 二次剖腹产 

分 类 号：R719.8[医药卫生—妇产科学]