摘要
目的探究腹壁切口选择对二次分娩剖宫产手术的影响。方法研究对象选取为2020年1月至2021年4月在睢县妇幼保健院分娩的104例二次剖宫产产妇,按照产妇首次剖宫产的腹壁切口不同进行分组,52例腹壁横切口产妇设为横切组,52例经腹纵切口产妇设为纵切组,两组产妇二次剖宫产手术时均在原切口上切开腹壁入腹,对比两组产妇的术中出血量、胎儿娩出时间、手术时间、腹腔粘连程度,并对比两组产妇恢复质量评分量表(QoR-40)评分、首次肛门排气、泌乳时间、瘢痕严重程度以及并发症发生情况。结果与横切组相比,纵切组产妇二次手术的术中出血量、胎儿娩出时间、手术时间、腹腔粘连程度均显著低于横切组,两组差异有统计学意义(P<0.05);两组产妇术前24 h QoR-40量表各维度评分及总评分比较差异均无统计学意义(P<0.05),两组产妇术后QoR-40量表总体评分及各维度评分均低于术前,差异有统计学意义(P<0.05),且横切组产妇术后QoR-40量表总分以及情绪状态、身体舒适度、疼痛三个维度评分均明显高于纵切组,差异有统计学意义(P<0.05);两组产妇首次肛门排气、泌乳时间对比,差异无统计学意义(P>0.05);纵切组产妇瘢痕严重程度明显高于横切组,差异有统计学意义(P<0.05),但两组产妇的术后并发症对比,差异无统计学意义(P>0.05)。结论相对于腹壁横切口而言,纵切口手术有利于降低腹腔粘连,减少手术时间,更适合于二次分娩剖宫产术,但切口美观度较低。
Objective To investigate the effect of abdominal incision type for secondary cesarean section operation.Methods A total of 104 pregnancy women who accepted secondary cesarean section operation in my hospital from January 2020 to April 2021 were randomly divided into transverse incision group(N=52)and longitudinal incision group(N=52)by abdominal incision type of primary cesarean section,and they adopted the same approach into abdominal cavity at second operation.The total bleeding volume in operation,fetal delivery time,total operation time,peritoneal adhesion degree,QoR-40 scale score before and after treatment,first exhaust time,first lactation time,scar severity and postoperative complication were compared between the two groups.Results Compared with the transverse incision group,the total bleeding volume in operation,fetal delivery time,total operation time,peritoneal adhesion degree in the longitudinal resection group were significantly lower than those in the transverse incision group,with statistical significance(P<0.05).There were no significant differences in the QoR-40 scores before cesarean section between the two groups(P>0.05).After operation,the overall score of QoR-40 scale and the score of all dimensions in the two groups were lower than those before operation(P<0.05),and the emotional state score,physical comfort score,pain scores and overall scores in transverse incision group were higher than those in longitudinal incision group(P<0.05).There were no significant differences in the first exhaust time and first lactation time after cesarean section between the two groups(P>0.05).The scar severity of the longitudinal incision group after operation was higher than that of the transverse incision group(P<0.05).The two groups showed no significant difference in postoperative complication(P>0.05).Conclusion Compared with abdominal transverse incision,abdominal longitudinal incision of primary cesarean section is more suitable for secondary cesarean section and is beneficial to reduce abdominal adhesio
作者
徐金凤
XU Jinfeng(Department of Obstetrics,Suixian Maternal and Child Health Hospital,Shangqiu Henan 476900,China)
出处
《临床研究》
2022年第10期72-75,共4页
Clinical Research
关键词
二次剖宫产
首次剖宫产切口
腹壁横切口
腹壁纵切口
腹腔粘连
secondary cesarean section
abdominal incision of primary cesarean section
abdominal transverse incision
abdominal longitudinal incision
abdominal adhesion
