剖宫产术后腹壁切口愈合不良行II期缝合的相关因素分析  

作　　者：叶雨蓝 吴燕 马蔷 

机构地区：[1]浙江省嘉兴市妇幼保健院(浙江省嘉兴学院附属妇儿医院),314050

出　　处：《浙江临床医学》2023年第3期416-417,437,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022KY391);嘉兴市科技计划项目(2020AD10033)。

摘　　要：目的通过探讨剖宫产术后腹壁切口愈合不良行II期缝合的危险因素,降低II期缝合的发生概率。方法回顾性分析2021年1月至2021年10月收治的69例行剖宫产手术的患者资料。根据是否发生术后腹壁切口愈合不良并行II期缝合将患者分为观察组(n=10)和对照组(n=59)。结合年龄、体重指数(BMI)、是否合并GDM、是否术前胎膜早破、阴道检查次数、手术时间、术中出血量、术中羊水颜色是否正常、剖宫产术后第3天CRP值、切口分泌物培养结果等因素进行单因素分析及二分类Logistic回归分析。结果单因素分析结果示,阴道检查次数、新生儿窒息、BMI等观察指标与剖宫产术后的腹壁切口愈合不良行II期缝合有关(P<0.05)。二分类Logistic回归分析结果示,阴道检查次数(OR=1.255,95%CI:1.001~1.573,P=0.049),BMI(OR=1.271,95%CI:1.008~1.602,P=0.042)是剖宫产术后的腹壁切口愈合不良行II期缝合的独立危险因素。结论剖宫产术后的腹壁切口愈合不良行II期缝合的相关因素中围产期的阴道检查次数、BMI为其独立危险因素,在临床工作中,要加强孕期、围产期的管理,以减少剖宫产术后的腹壁切口愈合不良行II期缝合的发生率。Objective To investigate the risk factors of stage II suture for poor incision healing of abdominal wall after cesarean section,and to reduce the occurrence probability of stage II suture.Methods Data of 69 patients undergoing cesarean section in our hospital from January 2021 to October 2021 were retrospectively analyzed.Patients were divided into the case group(n=10)and the control group(n=59)according to the occurrence of poor postoperative abdominal wall incision healing and stage II suture.Univariate analysis and binary Logistic regression analysis were combined with age,body mass index(BMI),combined with GDM,preoperative premature rupture of membranes,number of vaginal examinations,operation time,intraoperative blood loss,normal color of amniotic fluid,C-reactive protein(CRP)value on the third day after cesarean section,incision secretion culture results and other factors.Results Univariate analysis showed that the number of vaginal examinations,neonatal asphyxia,BMI and other indicators were related to poor abdominal wall incision healing and stage II suture after cesarean section,with statistical significance(P<0.05).The results of binary Logistic regression analysis showed that the number of vaginal examinations(OR=1.255,95%CI:1.001~1.573,P=0.049)and BMI(OR=1.271,95%CI:1.008~1.602,P=0.042)was an independent risk factor for poor abdominal wall incision healing and stage II suture after cesarean section.Conclusion Perinatal vaginal examination times and BMI are independent risk factors for poor incision healing of abdominal wall after cesarean section.In clinical work,management of pregnancy and perinatal period should be strengthened to reduce the incidence of poor incision healing of abdominal wall after cesarean section and stage II suture.

关 键 词：剖宫产 腹壁切口 II期缝合相关因素 

分 类 号：R719.8[医药卫生—妇产科学]