不同剖宫产术式对产妇盆腹腔及腹壁粘连的对比研究

doi:10.3969/j.issn.1674-490X.2015.06.010

医学研究与教育 ›› 2015, Vol. 32 ›› Issue (6): 44-48.DOI: 10.3969/j.issn.1674-490X.2015.06.010

不同剖宫产术式对产妇盆腹腔及腹壁粘连的对比研究

刘秀军¹，孟丽芳²

1. 玉田县计划生育中心医院，河北玉田 064100；2. 玉田县妇幼保健所，河北玉田 064100

出版日期:2015-12-25 发布日期:2015-12-25
通讯作者: 孟丽芳（1969—），女，河北玉田人，主治医师，主要从事妇产科临床。E-mail: 97289199@qq.com
作者简介:刘秀军（1971—），女，河北玉田人，主治医师，主要从事妇产科临床。

Comparative study of different methods of cesarean section on the influence of intra-abdominal adhesion and abdominal wall adhesions of parturients

LIU Xiujun¹, MENG Lifang²

1. Center Hospital of Family Planning of Yutian, Yutian 064100, China; 2. Health Care Institutions for Women and Children of Yutian, Yutian 064100, China

Online:2015-12-25 Published:2015-12-25

摘要/Abstract

摘要： 目的探讨不同剖宫产术式对产妇盆腹腔及腹壁粘连的影响。方法 115 例行再次剖宫产的产妇，根据首次剖宫产的术式不同分为 Stark 式剖宫产组（62 例）和下腹纵切口式剖宫产组（53 例）。观察并评价 2 组产妇首次剖宫产切口的愈合情况，粘连的部位及程度，记录再次剖宫产术时的开腹时间、手术时间及术中出血量。结果 Stark 式剖宫产组切口愈合较好，瘢痕纤细率（87.10%）显著高于下腹纵切口式剖宫产组（30.19%）（P<0.05），粘连发生率 [4.84%（3/62）] 显著低于下腹纵切口式剖宫产组 [16.98%（9/53）]（P<0.05），大网膜与腹壁切口粘连（3.23%）、大网膜与子宫下段粘连（1.61%）、膀胱与子宫中段粘连（0）及膀胱与子宫下段粘连（0）的发生率均显著低于下腹纵切口式剖宫产组（7.55%、 3.77%、3.77%、1.89%）（P<0.05）。Stark 式剖宫产组开腹时间较下腹纵切口式剖宫产组长（P<0.05），术中出血量较下腹纵切口式剖宫产组大（P<0.05），但 2 组手术时间差异无统计学意义（P>0.05）。结论 Stark 式剖宫产术虽然存在术中出血量较大的可能，但其在切口愈合、减少盆腹腔及腹壁粘连方面均较传统的下腹纵切口式剖宫产术具有明显的优势，对产妇再次剖宫产的影响较小，值得临床推广使用。

关键词: 剖宫产, 粘连, 再次手术

Abstract: Objective To investigate the influence of different methods of cesarean section on intra-abdominal adhesion and abdominal wall adhesions of parturients. Methods A total of 115 parturients performed repeated cesarean were divided into stark group (received Stark cesarean section, 62 cases) and routine group (received longitudinal incision cesarean section). The healing of incision for previous cesarean section, location and degree of adhesion of the two groups were observed and evaluated, the open procedure time, operation time and perioperative blood loss of the two groups were recorded. Results The results showed the recovery of healing of incision of the sark group was better, the fine scar rate was 87.10%, which was significantly higher than that of in routine group(30.19%), (P<0.05), the incidence of adhesion was 4.84%(3/62), which was statistically lower than that of in routine group(16.98%), (P<0.05), among them, the incidences of adhesion between colic omentum and abdominal wall (3.23%) as well as lower uterine segment (1.61%), bladder and middle uterinesegment (0) as well as lower uterine segment (0) were all obviously lower than those of in routine group (7.55%, 3.77%, 3.77% and 1.89% respectively)(P<0.05). The open procedure time of Stark group was statistically longer than that of routine group (P<0.05), perioperative blood loss was statistically less than that of routine group (P<0.05), but no statistical difference in operation time was observed between the two groups (P>0.05). Conclusion Although stark cesarean section has more perioperative blood loss, it has obvious advantages in the recovery of incision, reducing intra-abdominal adhesion and abdominal wall adhesions than longitudinal incision cesarean section, which has little influence on repeated cesarean of parturients, thus it is worthy of extensively applied in clinic practices.

Key words: cesarean section, adhesion, repeated surgery

中图分类号:

R246.3

刘秀军，孟丽芳. 不同剖宫产术式对产妇盆腹腔及腹壁粘连的对比研究[J]. 医学研究与教育, 2015, 32(6): 44-48.

LIU Xiujun, MENG Lifang. Comparative study of different methods of cesarean section on the influence of intra-abdominal adhesion and abdominal wall adhesions of parturients[J]. Medical Reserch and Education, 2015, 32(6): 44-48.

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不同剖宫产术式对产妇盆腹腔及腹壁粘连的对比研究

Comparative study of different methods of cesarean section on the influence of intra-abdominal adhesion and abdominal wall adhesions of parturients

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