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对72例子宫下段形成不良的孕妇首次剖宫产子宫切口选择的临床观察

  • 彭广涛

* 通信作者: 彭广涛, 单位:桂林市人民医院 541002

摘要

[摘 要]
目的:探讨子宫下段未形成的孕妇首次剖宫产手术部位的选择对术口愈合及再次手术术中出血的影响,以期选择最合理的手术方式,减少、减轻手术并发症。

方法:选取2012年1月~2015年12月两次均在我医院住院由同一组医师实施剖宫产术者72例进行回归性研究,这72例均为子宫下段未完全形成孕妇(即均为妊娠32±2周未临产但合并内科疾病或产科重症,已经影响胎儿需提前终止妊娠的孕妇)。其中观察组30例(首次剖宫产术子宫切口选择切开膀胱反折腹膜并下推膀胱,子宫切口位置均为子宫下段腹膜反折缘下2cm之中线处);对照组42例(将首次剖宫产子宫切口选择在膀胱腹膜反折上0.5cm处),对比两组患者再次剖宫产手术开腹后所见子宫愈合情况及术中出血率、出血量的情况。

结果:对比两组患者再次剖宫产手术开腹后所见子宫愈合情况,两组子宫愈合不良的概率相比,P>0.05,差异无统计学意义;比较两组患者再次剖宫产术中出血率及出血量情况,观察组术中出血率20% ,出血量250.2±42.03ml,对照组术中出血率30.95%,出血量 409±49.22ml,两组相比,P<0.05,差异有统计学意义。

结论:对于子宫下段形成不良的孕妇首次剖宫产子宫切口可以切开膀胱反折腹膜并下推膀胱,可有利再次剖宫产的手术操作,有效地减少术中出血。

关键词:[关键词] 剖宫产;再次剖宫产;愈合; 出血

ABSTRACT

[Abstract]
Objective: To study the lower uterine segment has not formed the pregnant women for the first time cesarean section surgical site selection of incision healing and re operation effects of intraoperative hemorrhage, in order to choose the most reasonable operation mode, reduce, reduce surgical complications.

Methods: 72 cases of cesarean section in our hospital from January 2012 to December were selected in our hospital by the same group of physicians in two cases, the 72 cases were not pregnant women in the lower part of the uterus. Which observation group (n = 30) (first splits the palace production of uterine incision incision of bladder anti fold of peritoneum and push the bladder, uterine incision position are uterine lower segment of the peritoneum margin of 2 cm of the midline), 42 cases of the control group (the first cesarean section uterine incision selection in bladder peritoneum anti fold 0.5cm). After comparing the two groups of patients again Caesarean birth surgery see uterine healing and intraoperative hemorrhage rate, the amount of bleeding.

Results: after comparing the two groups of patients again Caesarean birth surgery see uterine healing, compared two groups of uterine healing of the probability, P > 0.05, the difference was not statistically significant; compared two groups of patients with cesarean section operation bleeding and bleeding volume, the observation group, intraoperative hemorrhage rate of 20%, bleeding 250.2 ~ + 42.03ml, control group, intraoperative hemorrhage rate of 30.95%, bleeding 409 + 49.22ml, two groups compared, P < 0.05, the differences have statistical significance.

Conclusion  : for the first time in the lower uterine segment of pregnant women with cesarean section incision can cut the bladder and push the bladder, which can be beneficial to the operation of cesarean section again, effectively reduce the bleeding during operation.

Key words: [Key words] cesarean section; cesarean section; healing; bleeding

引用本文 / How to Cite This Article

彭广涛.对72例子宫下段形成不良的孕妇首次剖宫产子宫切口选择的临床观察[J]. 国际精神病学杂志, , (): -

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