摘要
目的探讨剖宫产切口憩室发生的危险因素及全层缝合技术的应用效果。方法选择2014~2016年于贵港市人民医院就诊的子宫切口憩室(previous cesarean scar defect,PCSD)患者60例为病例组,另选此期间行剖宫产术后子宫切口愈合良好者120例为对照组。回顾性分析两组临床病历资料,包括一般情况、妊娠期合并症、胎膜早破、白细胞异常升高、子宫瘢痕情况、后位子宫、宫腔分离、手术时机、切口缝合方式,分析剖宫产切口憩室发生的危险因素及全层缝合技术的应用效果。结果病例组出现妊娠合并症(35.00%)、白细胞异常升高比例(76.67%)、瘢痕子宫(45.00%)、后位子宫(60.00%)及宫腔分离比例(28.33%)均高于对照组(7.50%、49.17%、24.17%、28.33%、13.33%),差异有统计学意义(P<0.05),各时期手术时机比较差异无统计学意义(P>0.05);病例组全层缝合比例(8.3%)低于对照组(72.5%),差异有统计学意义(P<0.05)。结论妊娠合并症、术后白细胞升高、子宫位置、缝合方式为PCSD形成的高危因素。而剖宫产次数、宫腔分离、产程程度对PCSD形成无统计学意义。因此,把握剖宫产手术的适应证,同时选择较为稳妥的全层缝合技术是减少PCSD发生的有效措施。
Objective To investigate the risk factors of cesarean section diverticulum and the effect of full-thickness suture technique.Methods 60 patients with previous cesarean scar defect（ PCSD） who were admitted to Guigang People ＇s Hospital from2014 to 2016 were selected as the case group.At the same time,120 patients with good uterine incision cured after cesarean section were selected as control group.Retrospective analysis of two groups of clinical medical records,including general conditions,gestational comorbidities,premature rupture of membranes,white blood cells abnormal rise,uterine scars,posterior uterus,uterine cavity separation,timing of surgery and incision suture to analyze the risk factors of diverticulum in the cesarean section and the application effect of full-thickness suture technique.Results The incidence of pregnancy complications（ 35.00 %）,leukocyte elevation（ 76.67 %）,the scar uterus（ 45.00 %）,posterior uterus（ 60.00 %） and uterine cavity separation ratio（ 28.33 %） of the case group were higher than the control group（ 7.50%,49.17 %,24.17 %,28.33 %,13.33 %）,the difference was statistically significant（ P 0.05）.There was no significant difference in the timing of operation between the two groups（ P 0.05）.The proportion of full-thickness suture in the case group（ 8.3 %） was lower than that in the control group（ 72.5 %）.The difference was statistically significant（ P 0.05）.Conclusion Pregnancy complications,postoperative white blood cells,uterine location,and suture methods are high-risk factors for PCSD formation.The number of cesarean section,uterine cavity separation,and degree of labor were no significant for PCSD formation.Therefore,grasping the indications for cesarean section surgery,and selecting a more stable full-layer suture technique is a way to effectively reduce the occurrence of PCSD.
作者
尧美茜
YAO Mei-qian(Department of Obsterics,Guigang People＇s Hospital,Guigang Guangxi 537100,P.R.China)
出处
《中国计划生育和妇产科》
2018年第8期82-85,共4页
Chinese Journal of Family Planning & Gynecotokology
关键词
剖宫产
瘢痕憩室
危险因素
cesarean section
diverticulum
risk factors
