新式剖宫产术及其改进术后腹壁粘连情况分析.doc

新式剖宫产术及其改进术后腹壁粘连情况分析 【摘要】目的：分析新式剖腹产及其改进术后腹壁粘连情况，以期改进现有手术方式，减少或减轻术后并发症的发生。方法：采用回顾性分析的方法，对650例新式剖腹产术后再次剖腹产术腹壁粘连情况进行分析。其中450例不缝合腹膜及腹直肌腱划（包括小部分腹直肌）（A组）；200例采用缝合腹膜及腹直肌腱划（包括小部分腹直肌）（B组）。比较其腹壁切口粘连情况，均有不同程度的粘连。结果：A组165例（37%）有粘连情况（轻-重）；B组42例（21%）有粘连情况（轻），无明显重度粘连。两组腹壁粘连比较差异有显著性（P0.01）。结论：新式剖腹产术缝合腹膜及腹直肌腱划可以减少腹壁粘连程度；降底再次手术难度。 【关键词】 新式剖宫产 改进术 腹壁粘连 The Analysis of The New Caesarean Section and The Improvement of Postoperative Abdominal Wall Adhesions WU Shu-ling，ZHU Zhen-huan，HONG Qiao-lian (Dparment of Obstetrics and Gynecology, Jinjiang Hospital , Fujian 362200,China) 【Abstract】 Objective：To analyze the new caesarean section and the improvement of postoperative abdominal wall adhesions, with a view to improve existing operations, reduce or mitigate the occurrence of postoperative complications. Methods:By retrospective analysis method, New Caesarean section after another 650 cases of caesarean section analysis of abdominal adhesions. Of which 450 cases of non-closure of peritoneum and rectus abdominis tendon (including small partial rectus abdominis) (group A); 200 cases of closure of peritoneum and rectus abdominis tendon (including small partial rectus abdominis) (group B). Compared with the abdominal wall adhesions, they all have different levels of adhesion.Results: Group A 165 cases (37%) have adhesions (tolerant -severe); Group B 42 cases (21%) adhesions(tolerant), no severe adhesions. Abdominal adhesions statistically significant difference between the two groups (P0.01).Conclusions: The new caesarean section technique which sutures peritoneum and rectus abdominis tendon could reduce abdominal adhesions; Lower reoperation difficulty. 【Key words】New cesarean section; Modified operations; Abdominal wall adhesions Stark式剖宫产术是1996 年以色列的Stark教授介绍到中国，我院于是2000年开展。Stark式剖宫产具有操作简单，手术时间短、损伤小、出血少、恢复快、疼痛轻、美观等优点取得同行的肯定。但是其不缝合壁层腹膜及膀胱反折仍存在严重的并发症。在基层医院第二次剖腹产较常见，笔者通过改进手术方式观察术后腹壁粘连情况进行比较，结果发现改进手术方式可以减少术后并发症的发生；降低二次手术难度。本文通过对比观察分析新式剖宫产术及其改进术导致腹壁粘连情况，现将结果报道如下。 1 资料与方法 1.1 一般资料 选择我院200