剖宫产术后盆腔重度粘连的相关因素分析  

Analysis of Related Factors of Severe Pelvic Adhesion after Caesarean Section

作　　者：杨雪[1] 赵丽娟[1] 吴帼蕴 YANG Xue;ZHAO Lijuan;WU Guoyun(Nanjing Medical University Fourth Affiliated Hospital Obstetrics and Gynecology,Nanjing Jiangsu 210031,China)

机构地区：[1]南京医科大学第四附属医院妇产科,南京210031

出　　处：《河南医学高等专科学校学报》2024年第2期159-163,共5页Journal of Henan Medical College

摘　　要：目的探讨剖宫产术后盆腔发生重度粘连的相关影响因素。方法回顾性分析在医院行盆腔手术的既往剖宫产手术患者89例的临床资料。统计患者剖宫产术后盆腔重度粘连的发生率,并采用单因素和多因素logistic回归分析剖宫产术后发生盆腔重度粘连的危险因素。结果89例患者剖宫产术后发生盆腔重度粘连8例,占8.99%;单因素分析显示:羊水污染、剖宫产次数、子宫切口撕裂、术后感染、术中无清洗、有盆腔炎、子宫切口位置、无预防粘连药物使用与患者剖宫产术后发生重度盆腔粘连有关(P<0.05);多因素logistic回归分析显示:羊水污染、剖宫产次数、子宫切口撕裂、术后感染、术中无清洗、有盆腔炎、子宫切口位置、无预防粘连药物使用是诱导患者剖宫产术后发生盆腔重度粘连的独立影响因素(P<0.05)。结论导致剖宫产术后发生盆腔重度粘连的影响因素较多,因此进行剖宫产时应积极预防感染,避免撕破子宫切口延伸,同时减少羊水污染情况发生,降低剖宫产次数、选取合适的子宫切口位置、必要时可给予患者相应的药物进行预防,以降低盆腔重度粘连发生率。Objective To explore the related factors of severe pelvic adhesion after caesarean section.Methods A retrospective analysis was conducted on the clinical data of 89 patients who underwent pelvic surgery in the hospital and underwent previous cesarean section.The incidence of severe pelvic adhesions in patients after caesarean section was counted and the related risk factors were analyzed using univariate and multivariate logistic regression.Results Eight cases of severe pelvic adhesions occurred after cesarean section in 89 patients(8.99%).Univariate analysis showed that amniotic fluid contamination,number of cesarean sections,uterine incision tears,postoperative infections,absence of intraoperative cleansing,presence of pelvic inflammatory disease,location of uterine incision,and absence of adhesion-preventive medication use were associated with the occurrence of severe pelvic adhesions in patients after cesarean section(P<0.05).Multifactorial logistic regression analysis showed that contaminated amniotic fluid,number of cesarean sections,uterine incision tear,postoperative infection,absence of intraoperative cleansing,presence of pelvic inflammatory disease,location of uterine incision,and absence of adhesion-preventing medication use were the independent influencing factors that induced the development of severe pelvic adhesions in patients after cesarean section(P<0.05).Conclusion There are many factors affecting the occurrence of severe pelvic adhesions after cesarean section,therefore,when performing cesarean section,we should actively prevent infections,avoid tearing the extension of the uterine incision,and at the same time reduce the occurrence of amniotic fluid contamination,reduce the number of cesarean sections,select the appropriate location of the uterine incision,and if necessary,give the patient the appropriate medication for prevention to reduce the incidence of pelvic severe adhesions.

关 键 词：剖宫产 盆腔重度粘连 临床情况 影响因素 预防对策 

分 类 号：R719.8[医药卫生—妇产科学]