摘要
目的:探析二次剖宫产术中原子宫切口瘢痕切除与否对剖宫产切口瘢痕憩室(PCSD)形成的影响。方法:抽选本院2015年8月—2017年2月收治的二次剖宫产产妇408例,双盲法分组做前瞻性观察,观察组204例,剖宫产手术中直接经由前次切口瘢痕进行切除,并结合子宫瘢痕特点采取个体化切口缝合处理;对照组204例,剖宫产术后在瘢痕切口点实施双层连续缝合法。比较两组产妇临床指标,术后恢复效果,持续观察15个月,记录PCSD发生率。结果:两组术中出血量、手术耗时、术后3d内最高体温对比无统计学差异(P>0.05);观察组恶露持续时间、产后出血率、盆腔粘连率均低于对照组(P<0.05);两组住院时间、肛门排气时间比较无统计学差异(P>0.05);观察组术后月经异常率与PCSD发生率均低于对照组,术后15个月PCSD残余子宫的肌层厚度高于对照组,PCSD容积小于对照组(均P<0.05)。结论:二次剖宫产术中进行原子宫切口瘢痕切除,并给予个体化切口缝合处理能够有效避免切口不良愈合,减少PCSD的形成风险。
Objective To investigate the effect of scar resection on the scar diverticulum （PCSD） formation of women with secondary cesarean section. Methods： 408 women with second cesarean section in Qingbaijiang district People＇s hospital of Chengdu city from August 2015 to February 2017 were selected, and were divided randomly into observa- tion group （204 cases） and control group （204 cases）. Women in observation group were resected previous incision scar directly during cesarean section, and the treatment of individualized incision suture was adopted based on characteristics of uterine scar. Women in control group were treated with double layer continuous suture at the scar incision point dur- ing cesarean section. The clinical indexes and postoperative recovery were compared between the two groups. And the incidence of PCSD formation in both groups was followed up to 15months after deliver. Results; There were no signifi- cant different in the amount of intraoperative bleeding, the operation time, the maximum body temperature within 3 days after operation between the two groups （P〉0.05）. The duration of lochia, the rate of postpartum hemorrhage, and the rate of pelvic adhesion of women in observation group were significant lower than those of women in control group （P〈0.05）. The hospital stay time, and the time to anal exhaust time had no significant different （P〉0.05）. The abnormal menstrual rate and incidence of PCSD of women in observation group were significant lower than those of women in control group （P〈0.05）. 15 months after operation, the average myometrium thickness at PCSD point of women in observation group was significant higher than that of women in control group, and volume of PCSD of women in observation group was significant less than that of women in control group （P〈0.05）. Conclusion： Women who had experienced cesarean are reseeted previous incision scar directly during secondary cesarean section, and are given individualized incision suture, which can
作者
冷红
LENG Hong(Qingbaijiang District People＇s Hospital of Chengdu City,Sichuan Province,610300)
出处
《中国计划生育学杂志》
2018年第9期819-822,共4页
Chinese Journal of Family Planning
关键词
二次剖宫产
子宫切口瘢痕切除
剖宫产切口瘢痕憩室
Secondary cesarean section
Scar resection of uterine incision
previous cesarean scar defect
