新式剖宫产术与腹部纵切口子宫下段剖宫产术后腹腔粘连情况比较

目的:探讨剖宫产术后腹腔粘连情况及产生原因,以期通过改良手术方式减少其发生率。方法:对1996年3月~2005年8月于清华大学第一附属医院产科再次行剖宫产术病例140例进行回顾性分析,比较其腹腔粘连情况。结果:新式剖宫产术和子宫下段剖宫产术后发生腹腔粘连者分别34例和70例,发生率分别为94.4%和67.3%,差异有统计学意义(P<0.01)。前组中腹壁及腹腔广泛粘连发生率较高,与后者比较,差异有统计学意义(P值分别为<0.05、<0.01)。而轻度粘连在两组中的发生率相近,差异无统计学意义(P>0.05)。发生腹腔粘连及粘连程度与术后时间间隔长短无关,并不随着术后时间的延长而发生变化,差异无统计学意义(P>0.05)。结论:新式剖宫产术后的腹腔粘连发生率较子宫下段剖宫产术高,并且程度较为严重。

The new mode and midline incision for caesarean section and abdomen cavity adhesions

Objective:To evaluate the cause of abdomen cavity adhesions after caesarean section, and to reduce the risk of adhesions by improving the operation methods.Methods:140 cases of abdomen cavity adhesions women who had a second caesarean section between March 1996 to August 2005 were studied retrospectively.Results:34 cases(94.4%) developed abdomen cavity adhesions in the new mode caesarean section group, while 70 cases(67.3%) in midline incision group. This difference was statistically significant (P< 0.01). New mode caesarean section was associated with more extensive adhesions of abdomen wall and abdomen cavity than midline incision, which were statistically significant too (P< 0.05,P<0.01). Less serious degree of adhesions did not differ between the two groups (P>0.05). There was no statistically significant association between abdomen cavity adhesions and the time interval of repeat operation.Conclusion:New mode caesarean section is associated with higher rate and more serious degree of abdomen cavity adhesions.