再次剖宫产126例临床分析

目的 探讨腹壁纵切口及横切口剖宫产术式对再次剖宫产的影响。方法 选择腹壁纵切口剖宫产术后再次剖宫产产妇68例为A组,腹壁横切口再次剖宫产58例为B组,对两组开腹至胎儿取出时间、手术总时间、腹壁及盆腹腔粘连情况、术中出血量、子宫切口愈合情况进行比较。结果 A组开腹至胎儿取出时间、手术总时间均短于B组,差异有统计学意义(P<0.05);A组腹壁及盆腹腔重度粘连少于B组,差异有统计学意义(P<0.05);两组盆腹腔轻、中度粘连及术中出血量、子宫切口愈合情况差异无统计学意义(P>0.05)。结论 腹壁横切口剖宫产术后粘连较严重,给再次手术增加了难度。对有可能行再次剖宫产的产妇,首次手术选择腹壁纵切口是一种明智的选择。

Cinical analysis of re-cesarean section in 126 cases

Objective To study the effect on abdominal vertical incision and transverse incision to re-cesarean section.Methods The samples of re-cesarean section in 68 cases with vertical incision were in Group-A and other samples of re-cesarean section in 58 cases with transverse incision were in Group-B.The data about the time from operation beginning to fetus taken-off,cumulative time of whole operation,adherent status of abdominal wall and abdomino-pelvic cavity,intra-operative blood loss,uterine wound healing station were analyzed and compared between two groups.Results The time from operation beginning to fetus taken-off,cumulative time of whole operation in Group-A were shorter than those in Group-B that the difference was significant(P<0.05).Cases with severe adhesion of abdomino-pelvic cavity in Group-A were less than that in Group-B that the difference was significant(P<0.05).The difference on light and midrange adhesion of abdomino-pelvic cavity,the amount of blood loss,wound healing were no significant between two groups(P>0.05).Conclusion More adhesion is in abdomino-pelvic cavity after abdominal transverse incision of cesarean section that leads to more difficulty to repeat cesarean section.So abdominal vertical incision will be the wise choice for the cases with re-cesarean section.