子宫瘢痕切除对第二次剖宫产术后恢复、瘢痕憩室形成的影响  

作　　者：盛慧清 张荣 卫宏 张甦 

机构地区：[1]浙江省长兴县中医院,313100 [2]浙江省湖州市妇幼保健院,313000

出　　处：《浙江临床医学》2022年第6期887-889,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨第二次剖宫产子宫瘢痕切除对产妇术后恢复、子宫瘢痕憩室形成的影响。方法52例拟行第二次剖宫产产妇按照随机数字表法分为观察组和对照组,每组各26例。观察组,术中将原子宫瘢痕切除后缝合子宫切口;对照组,不切除原瘢痕直接缝合切口。比较两组子宫切口处理缝合时间、术中出血量、术后血性恶露持续时间、术后24 h血红蛋白水平,并使用彩色多普勒超声探测术后42 d、术后6个月、术后1年子宫切口处残余肌层厚度,观察术后1年憩室形成情况,测量憩室最大深度及憩室容积。结果观察组的子宫切口处理缝合时间长于对照组,恶露持续时间短于对照组。术后6个月,B超测量子宫切口残余肌层厚度大于对照组,术后1年子宫切口憩室发生率(15.4%)低于对照组(42.3%),憩室最大深度小于对照组,差异均有统计学意义(P均<0.05)。两组术中出血量、术后24 h血红蛋白水平接近,差异无统计学意义(P均>0.05)。结论子宫瘢痕切除有利于子宫切口组织构建恢复,减少瘢痕憩室的发生。Objective To investigate the effect of uterine scar resection in the second cesarean section on the postoperative recovery and the formation of uterine scar diverticulum.Methods 52 pregnant women who planned to undergo the second cesarean section were randomly divided into observation group and control group,with 26 cases in each group.In the observation group,atomic uterine scar was removed and uterine incision was sutured,in the control group,the incision was directly sutured without removing the original scar.The treatment and suture time of uterine incision,intraoperative bleeding,duration of postoperative bloody lochia and hemoglobin level at 24 hours after operation were compared between the two groups.The residual myometrial thickness at the uterine incision was detected by color Doppler ultrasound at 42 days,6 months and 1 year after operation.The formation of diverticulum at 1 year after operation was observed,and the maximum depth and volume of diverticulum were measured.Results The treatment and suture time of uterine incision in the observation group was longer than that in the control group,and the duration of lochia was shorter than that in the control group.6 months after operation,the residual myometrial thickness of the uterine incision measured by B-ultrasound was greater than that of the control group,the incidence of uterine incision diverticulum at 1 year after operation(15.4%)was lower than that of the control group(42.3%),and the maximum depth of the diverticulum was smaller than that of the control group,with statistical significance(all P<0.05).There was no significant difference between the two groups in the amount of intraoperative bleeding and the level of hemoglobin 24 hours after operation(all P>0.05).Conclusion Uterine scar resection is conducive to the construction and recovery of uterine incision tissue and reduces the occurrence of scar diverticulum.

关 键 词：第二次剖宫产 瘢痕切除 缝合方式 瘢痕憩室 

分 类 号：R71[医药卫生—妇产科学]