首次剖宫产术腹壁切口选择对二次剖宫产术的影响  

Influence of abdominal wall incision selection for first cesarean section on second cesarean section

作　　者：曾秀花 胡风星 ZENG Xiuhua;HU Fengxing(Department of Obstetrics and Gynecology of Youxi County General Hospital,Sanming 365100 Fujian,China)

机构地区：[1]福建省尤溪县总医院妇产科,福建三明365100

出　　处：《中国民康医学》2022年第18期151-154,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察首次剖宫产术腹壁切口选择对二次剖宫产术的影响。方法:回顾性分析2019年3月至2021年3月在该院实施二次剖宫产术的78例产妇的临床资料,按照首次剖宫产术切口的不同分为观察组(腹壁纵切口)40例和对照组(腹壁横切口)38例。两组均再次实施剖宫产术,切口与首次保持一致,比较两组手术相关指标(手术时间、切皮至娩出胎儿时间、术中出血量、肛门排气时间)水平、盆腔粘连发生率、新生儿窒息率和剖宫产术切口甲级愈合率。结果:观察组手术时间、切皮至娩出胎儿时间和肛门排气时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);观察组盆腔粘连发生率为15.00%(6/40),低于对照组的36.84%(14/38),差异有统计学意义(P<0.05);观察组新生儿窒息率为2.50%(1/40),低于对照组的21.05%(8/38),差异有统计学意义(P<0.05);观察组剖宫产术切口甲级愈合率为95.00%(38/40),高于对照组的76.32%(29/38),差异有统计学意义(P<0.05)。结论:首次剖宫产术切口选择腹壁纵切口可提高二次剖宫产术切口甲级愈合率,降低手术相关指标水平、盆腔粘连发生率和新生儿窒息率,效果优于首次剖宫产术切口选择腹壁横切口。Objective:To observe influence of abdominal wall incision selection for first cesarean section on second cesarean section.Methods:The clinical data of 78 puerperae who underwent second cesarean section in this hospital from March 2019 to March 2021 were retrospectively analyzed,and they were divided into observation group(longitudinal abdominal wall incision)and control group(transverse abdominal wall incision)according to the incision of first cesarean section,each with 38 cases.Both groups underwent cesarean section again,and the incision was the same as the first one.The levels of operation-related indicators(operation time,time from skin incision to delivery of the fetus,intraoperative blood loss,and anal exhaust time),the incidence of pelvic adhesions,the neonatal asphyxia rate,and the grade A cesarean section incision healing rate were compared between the two groups.Results:The operation time,the time from skin incision to the delivery of the fetus and the anal exhaust time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).The incidence of pelvic adhesions in the observation group was 15.00%(6/40),which was lower than 36.84%(14/38)in the control group,and the difference was statistically significant(P<0.05).The neonatal asphyxia rate in the observation group was 2.50%(1/40),which was lower than 21.05%(8/38)in the control group,and the difference was statistically significant(P<0.05).Further,the grade A cesarean section incision healing rate in the observation group was 95.00%(38/40),which was higher than that in the control group,which was 76.32%(29/38),and the difference was statistically significant(P<0.05).Conclusions:Selecting the longitudinal abdominal wall incision for the first cesarean section can improve the grade A second cesarean section healing rate,and reduce the levels of surgery-related indicators,the incidence of pelvic adhesions,and the neonat

关 键 词：首次剖宫产 二次剖宫产 腹壁横切口 腹壁纵切口 盆腔粘连 甲级愈合率 

分 类 号：R719.8[医药卫生—妇产科学]