子宫下段瘢痕修剪术在瘢痕子宫二次剖宫产手术中的应用  

Application of Scar Trimming of Lower Part of Uterus in Second Cesarean Section of Scarred Uterus

作　　者：罗素阳 邹金梅 叶丽娟 李彩霞 孔文婷 梁思敏 LUO Su-yang;ZOU Jin-mei;YE Li-juan;LI Cai-xia;KONG Wen-ting;LIANG Si-min(Yingde City Hospital of Traditional Chinese Medicine,Guangdong Yingde 513000)

机构地区：[1]英德市中医院,广东英德513000

出　　处：《深圳中西医结合杂志》2021年第23期83-86,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：清远市社会发展领域科技计划项目资助课题(200806104561527)。

摘　　要：目的:研究瘢痕子宫行二次剖宫产手术中运用子宫下段瘢痕修剪术的临床疗效。方法:选取2019年4月至2020年10月于英德市中医院产科行二次剖宫产手术的50例瘢痕子宫产妇,用随机数字表法分组,对照组和观察组各25例。对照组行常规剖宫产手术,观察组在常规剖宫产手术过程中增加子宫下段瘢痕修剪术,比较两种手术方法对手术指标、母婴结局、术后憩室形成的影响。结果:两组产妇的手术时间相比并无显著差异(P>0.05),但比较两组产妇的术中出血量情况,发现观察组的出血量更少。观察组产妇的术后肛门排气时间和住院时间均短于对照组,差异具有统计学意义(P<0.05)。观察组产妇产后42 d和产后9个月的异常子宫出血率、痛经及慢性盆腔痛发生率均较对照组低,憩室形成率显著低于对照组,差异具有统计学意义(P<0.05)。经比较两组新生儿的窒息发生率、Apgar评分、体质量,差异均无统计学意义(P>0.05)。结论:瘢痕子宫二次剖宫产时修剪子宫下段瘢痕对术后子宫切口憩室形成能起到有效的预防作用,可减少术中出血量,降低产后出血的发生风险,同时有利于缩短术后康复时间改善临床症状。Objective To study the clinical effect of the scar pruning of lower uterine in the second cesarean section of the scarred uterus.Methods From April 2019 to October 2020,50 parturient with scarred uterus who underwent secondary cesarean section in the obstetrics department of Yingde City Hospital of Traditional Chinese Medicine were selected and grouped by random number table,25 cases in the control group and 25 cases in the observation group.The control group underwent conventional cesarean section operation,and the observation group added lower uterine scar trimming during the conventional cesarean section operation.The effects of the two surgical methods on surgical indicators,maternal and infant outcomes,and postoperative diverticulum formation were compared.Results There was no significant difference in the operation time between the two groups of parturients (P > 0.05),but comparing the intraoperative blood loss of the two groups of parturients,it was found that the observation group had less blood loss.The postoperative anal exhaust time and hospital stay of the observation group were shorter than those of the control group (P < 0.05).The incidence of abnormal uterine bleeding,dysmenorrhea and chronic pelvic pain in the observation group 42 days and 9 months postpartum were lower than those of the control group,and the rate of diverticulum formation was significantly lower than that of the control group (P < 0.05).After comparing the incidence of asphyxia,Apgar score,and body weight of the two groups of newborns,the result was found that the difference was not statistically significant (P > 0.05).Conclusion Scar uterus trimming of the lower uterine scar during the second cesarean section can effectively prevent the formation of diverticulum in the postoperative uterine incision,reduce the amount of intraoperative bleeding,reduce the risk of postpartum hemorrhage,and help shorten the postoperative recovery time improve clinial symptoms.

关 键 词：瘢痕子宫 二次剖宫产 子宫下段瘢痕修剪术 

分 类 号：R714.2[医药卫生—妇产科学]