分析再次剖宫产术中腹腔粘连的影响因素及热奄包对产妇术后疼痛的作用  

Analysis of the influencing factors of intra-abdominal adhesion during repeat cesarean section and the effect of hot dressing bag on postoperative pain of parturients

作　　者：程慧英 蒋芬芳 李琴 CHENG Huiying;JIANG Fenfang;LI Qin(Department of Obstetrics and Gynecology,Shangrao Health School/Shangrao Health School Affiliated Hospital/Guangfeng District Maternal and Child Health Hospital,Shangrao,Jiangxi,334600,China;Department of Ultrasound,Guangxin District Tra‐ditional Chinese Medicine Hospital,Shangrao,Jiangxi,334100,China;Department of Public Health Information Management,Taihe County Maternal and Child Health Hospital,Ji'an,Jiangxi,343700,China)

机构地区：[1]上饶卫生学校/上饶卫校附属医院/广丰区妇幼保健院产科,江西上饶334600 [2]上饶市广信区中医院超声科,江西上饶334100 [3]泰和县妇幼保健院公共卫生信息管理科,江西吉安343700

出　　处：《当代医学》2024年第23期138-141,共4页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202312347)。

摘　　要：目的分析再次剖宫产术中腹腔粘连的影响因素及热奄包对产妇术后疼痛的作用。方法选取2019年1月至2022年3月上饶卫校附属医院/广丰区妇幼保健院收治的300例行再次剖宫术分娩的产妇作为研究对象,术后均给予常规及和热奄包干预。分析产妇再次剖宫产分娩术中腹腔粘连情况,单因素及多因素Logistic回归分析再次剖宫产分娩产妇术中发生腹腔粘连的危险因素,分析所有产妇术后24、48、72 h疼痛情况[视觉模拟评分法(visual analogue scale,VAS)评分]。结果300例再次剖宫产分娩产妇中,术中无腹腔粘连211例,腹腔粘连89例,其中轻度粘连37例,中度粘连31例,重度粘连21例。单因素分析结果显示,腹腔粘连与无腹腔粘连产妇经腹壁手术切口类型、盆腔炎病史、剖宫产次数、其他腹腔手术史占比比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,经腹壁横向切口、盆腔炎病史、剖宫产次数≥2次、其他腹腔手术史是再次剖宫产分娩产妇术中发生腹腔粘连的危险因素(P<0.05)。产妇术后不同时间点VAS评分比较差异有统计学意义(P<0.05),其中术后48、72 h VAS评分均低于术后24,且术后72 h低于术后48 h,差异有统计学意义(P<0.05)。结论经腹壁横向切口、盆腔炎病史、剖宫产≥2次、其他腹腔手术史是再次剖宫产术中发生粘连的危险因素,热奄包干预可减轻再次剖宫产分娩术中腹腔粘连产妇的术后疼痛感。Objective To analyze the influencing factors of intra-abdominal adhesion during repeat cesarean section and the effect of hot dressing bag on postoperative pain of parturients.Methods 300 cases of parturients who underwent cesarean section again admitted to Shangrao Health School Affiliated Hospital/Guangfeng District Maternal and Child Health Hospital from January 2019 to March 2022 were selected as the study subjects,all of them were given routine and hot dressing bag intervention after surgery.The intra-abdominal adhesion during repeat cesarean section delivery was analyzed,univariate and multivariate Logistic regression analysis were used to analyze the risk factors of abdominal adhesions during repeat cesarean section delivery,and the pain status[visual analogue scale(VAS)score]of all parturients at 24,48 and 72 h after operation were analyzed.Results Among the 300 cases of cesarean delivery,211 cases had no intra-abdominal adhesion,89 cases had intra-abdominal adhesion,which including 37 cases of mild adhesion,31 cases of moderate adhesion and 21 cases of severe adhesion.The results of univariate analysis showed that there were significant difference in type of transabdominal wall surgical incision,history of pelvic inflammatory disease,number of cesarean section and history of other abdominal surgeries between parturients with and without abdominal adhesion(P<0.05).Multivariate Logistic analysis showed that transabdominal wall surgical incision,history of pelvic inflammatory disease,number of cesarean sections≥2 times and history of other abdominal surgeries were risk factors for intra-abdominal adhesions during repeat cesarean section(P<0.05).There were significant differences in VAS scores at different time points after operation in parturients(P<0.05);the VAS score at 48,72 h after operation were lower than that at 24 after operation,and the VAS scores at 72 h after operation waslower than that at 48 h after operation,and the differences were statistically significant(P<0.05).Conclusion Transverse inc

关 键 词：再次剖宫产 术中腹腔粘连 原因分析 热奄包 

分 类 号：R71[医药卫生—妇产科学]