摘要
目的探讨头次剖宫产术时不同手术方式术后腹腔黏连情况及对再次剖宫产的影响。方法对1998年1月至2005年8月再次剖宫产病例进行回顾性分析。其中头次手术为子宫下段剖宫产术142例(CS组),Stark剖宫产术(新式剖宫产手术)96例(SCS组)。两组共238例,均无其它开腹手术病史。对其中所见腹腔黏连程度,与子宫下段疤痕厚度、术中出血量、手术时间与术后病率及术后排气时间进行比较。结果有Stark剖宫产史的患者与有传统的子宫下段剖宫产术史的患者相比,再次剖宫产所见黏连程度高,手术时间长,术中出血量增多、术后排气时间长,差异有显著性(P<0.05);子宫下段疤痕厚度、术中出血量、术后病率相比差异无显著性。结论有Stark剖宫产术史者再次开腹难度增加,子宫下段与腹壁及膀胱黏连,分离困难,致使术中出血量增多、手术时间延长、术后排气时间延长。故头次剖宫产要慎重选择手术方式。
Objective To investigate the intra- abdominal adhesions and effect on the repeated csarean section after different patterns of first cesarean section. Methods 238 cases with repeated cesarean section, 142 cases with traditional low seginent cesarean section （CS group） and 96 cases with Micheal Stark cesarean section （SCS group） in two hospitals, dated from January 1998 to August 2005, were analyzed retrospectively. No history of other intra-abdominal operations was included. Their intra-abdominal adhesions degree,the thickness of low segment,intra-operative hemorrhage,the dura- tion of operation, postoperative morbidity rate and the time of fart after operation were compared. Results lntra-abdominal adhesions, the duration of operation,the average blood loss and the time of fart in SCS group significantly increased as compared with that of CS group; the thickness of low segment,rate of intra-operative hemorrhage and postoperative morbidity had no significant difference. Conclusion Patients with history of Micheal Stark cesarean section have more difficulty in their repeated operations. Low segment of uterus which often adheres to abdominal wall and bladder makes the separation hard and thus has more blood loss and longer operation time and slower recovery. So we must choose patterns of cesarean section carefully during the primary cesarean section.
出处
《同济大学学报（医学版）》
CAS
2006年第2期67-69,共3页
Journal of Tongji University(Medical Science)
关键词
再次剖宫产
STARK剖宫产术
腹腔黏连
术中出血
repeat cesarean section
micheal Stark cesarean section
intra-abdominal adhesions
intra-operative hemorrhage
