Stark术式对再次剖宫产的影响

目的探讨首次剖宫产选择stark术式术后的腹壁与腹腔粘连情况及对再次剖宫产的影响。方法将180例再次剖宫产病例纳入研究,按初次剖宫产术式分为观察组和对照组,每组90例。即对照组行传统子宫下段剖宫产术,观察组行新式剖宫产（即stark式剖宫产）。比较再次剖宫产的术中出血量、开腹时间、手术时间,重度粘连比率,术后24h肛门排气率及术后病率。结果观察组的开腹时间、术中出血量、重度粘连比率及术后病率均高于对照组,而术后24h肛门排气率低于对照组,组间比较有显著性差异（P〈0.05）;手术时间组间比较没有显著性差异（P〉0.05）。结论 Stark式剖宫产后腹壁、腹腔粘连情况较传统子宫下段剖宫产术严重,再次剖宫产易引起出血多、恢复时间长等不利因素,首次剖宫产要慎重选择手术方式。

The impact of stark style cesarean section on cesarean section

Objective To explore Stark as initial cesarean section surgical approach on postoperative abdominal wall,abdominal adhesions and the impact of cesarean section.Methods 180 patients need to re-cesarean section were included in the study.According to first-time cesarean section is divided into observation group and control group(n=90).The control group was given traditional lower uterine segment cesarean section,cesarean section observation group was OK(that is,stark style cesarean section).All clinical parameters were compared including blood loss,time abdominal,operative time,intraoperative adhesions,after 24h flatus and postoperative morbidity rates,etc.Results Observation group,time abdominal,blood loss,severe postoperative adhesions ratio and higher disease rates,and 24h after flatus was lower than the control group between the two groups are significantly different(P<0.05).The operation time group no significant difference between(P>0.05).Conclusion Stark-type abdominal wall after cesarean section,abdominal adhesions than traditional severe lower uterine segment cesarean section,cesarean section can lead to bleeding again,and long recovery time of unfavorable factors,the first cesarean section surgical procedure should be selected carefully.