瘢痕厚度测量与先兆子宫破裂及手术方法选择的相关性  

Correlation of Scar Thickness Measurement with Premature Uterine Rupture and Surgical Method Selection

作　　者：曾丽莉 刘洪云 黄仕雅 Zeng Li-li;Liu Hong-yun;Huang Shi-ya(Department of Obstetrics and Gynecology,Heping County People's Hospital,Heyuan 517200,Guangdong Province,China;Department of Ultrasound,Heping County People's Hospital,Heyuan 517200,Guangdong Province,China)

机构地区：[1]和平县人民医院产科,广东河源517200 [2]和平县人民医院超声科,广东河源517200

出　　处：《中外医药研究》2023年第1期141-143,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：河源市社会发展科技计划项目(编号:210718181602559)。

摘　　要：目的:探讨剖宫产子宫再孕36~40周瘢痕厚度测量与先兆子宫破裂发生及手术方法选择的相关性。方法:选取2022年1—8月和平县人民医院剖宫产后二次妊娠的产妇120例为观察对象,按照剖宫产后缝合方法不同分为麦穗式连接缝合组(n=57)和双层连接缝合组(n=63)。使用彩色多普勒超声分别对患者进行经腹超声检测和经阴道超声检测。观察不同妊娠周期对下段瘢痕厚度的影响,不同愈合分级对子宫破裂的影响,不同手术缝合方式对下段瘢痕厚度的影响,分析不同瘢痕愈合分级、妊娠周期、手术方法与瘢痕厚度的相关性。结果:36周产妇下段瘢痕厚度高于40周产妇,差异有统计学意义(P<0.05);Ⅰ级产妇子宫破裂率低于Ⅱ级产妇和Ⅲ级产妇,差异有统计学意义(P<0.05);双层连接缝合组瘢痕厚度高于麦穗式连接缝合组,差异有统计学意义(P<0.05);相关性分析显示,不同瘢痕愈合分级、手术方法与瘢痕厚度呈正相关(P<0.05),妊娠周期与瘢痕厚度呈负相关(P<0.05)。结论:36孕周的孕妇瘢痕厚度高于40周孕妇,双层连接缝合的手术方法对瘢痕厚度的影响更大,瘢痕愈合分级为Ⅲ级的患者对先兆子宫破裂发生率影响较大。Objective:To investigate the correlation between the measurement of scar thickness at 36~40 weeks of uterine repregnancy from cesarean delivery and the occurrence of premature uterine rupture and the choice of surgical method.Methods:One hundred and twenty cases of women with second pregnancy after cesarean delivery in Heping County People's Hospital from January to August 2022 were selected as observation subjects,and were divided into the group with wheaten connecting sutures(n=57)and the group with double-layer connecting sutures(n=63)according to the different methods of post-cesarean delivery sutures.Transabdominal ultrasound and transvaginal ultrasound were performed on patients using color Doppler ultrasound,respectively.The effects of different gestational cycles on the thickness of the lower segment scar,different healing grades on uterine rupture,and different surgical sutures on the thickness of the lower segment scar were observed,and the correlation between different scar healing grades,gestational cycles,and surgical methods and the thickness of the scar was analyzed.Results:The thickness of the lower segment scar was higher in 36-week mothers than in 40-week mothers,and the difference was statistically significant(P<0.05).The rate of uterine rupture was lower in gradeⅠwomen than in gradeⅡand gradeⅢwomen,and the difference was statistically significant(P<0.05).The scar thickness was higher in the double-layered connecting suture group than in the wheaten connecting suture group,and the difference was statistically significant(P<0.05).Correlation analysis showed that different scar healing grades and surgical methods were positively correlated with scar thickness(P<0.05),and gestational cycle was negatively correlated with scar thickness(P<0.05).Conclusion:The scar thickness was higher in 36 weeks of gestation than in 40 weeks of gestation,the surgical method of double-linked sutures had a greater effect on the scar thickness,and patients with grade III scar healing had a greater effect on the

关 键 词：剖宫产子宫再孕 麦穗式连接缝合 子宫破裂 瘢痕厚度 相关性 

分 类 号：R71[医药卫生—妇产科学]