剖宫产腹壁纵横切口对再次剖宫产术的影响

目的探讨剖宫产腹壁纵横切口对再次剖宫产术的影响。方法回顾性分析84例再次行剖宫产术产妇的临床资料,按照首次手术方式分为腹壁纵切口组与腹壁横切口组。结果纵切口组产妇的切皮至进腹时间、切开子宫至胎儿娩出时间、手术时间和术中出血量均明显少于横切口组(P<0.05或P<0.01)。纵切口组产妇的盆腹腔粘连明显低于横切口组(χ2=14.00,P<0.05)。纵切口组的新生儿窒息率、术后肛门排气时间、术后疼痛、术后病率和术后住院天数明显低于对照组(P<0.05或P<0.01)。结论腹璧纵切口较腹壁横切口对产妇的再次剖宫产术影响较小,对可能需再次手术的患者选择腹壁纵切口,可降低再次手术对母婴的伤害,降低手术的风险。

The effect of the types of abdominal incision for cesarean section on repeat cesarean section

Objective To explore the effect of the types of abdominal incision for cesarean section on repeat cesarean sec- tion. Methods The clinic data of 84 patients accepted repeat cesarean section was analyzed retrospectively. All the patients were divided to transverse incision group and longitudinal incisiongroup by the type of abdominal the incision. Results The times from skin-incising to entering the abdominal cavity and from uterus-incising to childbirth, operation time and opera- tive blood loss of longitudinal incisiongroup were significantly less than that of transverse incision group （P 〈 0.05 or P 〈 0.01）. The pelvic and peritoneal adhesion of longitudinal incisiongroup were also significantly less than that of transverse incision group （χ2=14.00, P 〈 0.05）, and so were neonatal asphyxia rate, anus exhaust time, postoperative pain andpostop- erative hospital stay （P 〈 0.05 or P 〈 0.01）. Conclusion For patients would get repeat cesarean section, choosing longitudi- nalabdominal incision effect less than choosing transverse incision, so longitudinalabdominal incision is a good choice for its reducing the maternal injury and operation risk.