新式剖宫产术对妇科手术的影响

目的：探讨新式剖宫产术对再次开腹妇科手术的影响。方法：回顾性分析本院2009年1月～2010年3月收治的115例产妇,首次均为新式剖宫产,3～5年内再次在本院行开腹妇科手术患者。对行新式剖宫产术患者再次开腹手术进行对比研究,探讨手术效果。结果：115例行新式剖宫产术产妇随访1～3年,患者子宫修复均良好,切口表面较平,多数患者切口能被腹壁皱褶遮盖,体表美观,12例产妇由于瘢痕体质较为明显,2例产妇由于皮下脂肪液化从而影响伤口愈合。行再次开腹妇科手术后,出现盆腔粘连31例,占27.0%,其中14例较为严重,子宫粘连前腹壁,帮光位于腹壁切口下方,大网膜呈纵隔样,再次开腹后手术难度系数增加,剥离过程中易损伤膀胱。结论：新式剖宫产术术式简单、操作时间短、患者术后恢复快,切口美观,但对再次妇科开腹手术会造成一定影响,值得临床关注。

The influence of new-style caesarean section on gynecological surgery

Objective：To explore the influence of new-style caesarean section on re-abdominal gynecological surgery.Methods：A retrospective analysis of 115 patients who were treated in our hospital from January 2009 to March 2010 was adopted.The 115 patients underwent new-style caesarean section for the first time and again underwent abdominal gynecological surgery after 3-5 years in our hospital.The effects of surgery were explored by comparing in 115 patients.Results：Followed-up 1-3 years after new-style caesarean section was carried out,the results showed that the wombs of patients were in good repair and the surface of incisal opening was flat.The incisal opening of majority patients could be covered by the folds of the abdominal wall and body surface of these patients were beautiful outlook,but the incisal opening of 12 cases were obvious because of scar diathesis and the wound healing of 2 cases was affected because of the colliquation of the subcutaneous fat.After abdominal gynecological surgery 115 patients were again carried out,the adhesions of cavitas pelvis occured in 31 cases,which were accounted for 27.0%.14 cases were serious among the 31 cases,their uterine adhered anterior abdominal wall,bladder located below the abdominal incisal opening,the greater omentum showed mediastinal appearance,which resulted in the increase of degree of difficulty in again laparotomy and the increase the probability of bladder injury during dissection.Conclusion：The new-style caesarean section is simple,short in the operation time,and patients are rapid in postoperative recovery,beautiful outlook in incisal opening.However,it made a certain impact on again gynecological laparotomy,which is worthy of attention in clinical.