标题：瘢痕子宫产妇二次剖宫产与非瘢痕子宫剖宫产的临床对照研究

      作者：孙丽，张丹，李佳    (辽宁电力中心医院妇产科，辽宁 沈阳 110000)

      卷次： 2018年29卷22期

      【摘要】 目的 对比瘢痕子宫产妇行二次剖宫产与非瘢痕子宫剖宫产并发症的发生情况，以明确瘢痕子宫行二次剖宫产手术的风险性。方法 选取辽宁电力中心医院妇产科于2016年5月至2018年5月期间收治的120例剖宫产瘢痕子宫产妇行二次剖宫产者纳入观察组，120例非瘢痕子宫进行剖宫产的产妇为对照组，比较两组产妇的手术时间、术中及产后出血量、恶露持续时间，同时记录术后并发症情况。结果 观察组产妇的手术时间、产后恶露时间分别为(59.4±18.8) min、(51.3±17.8) d，明显长于对照组的(46.2±16.5) min、(39.2±14.5) d，术中及产后出血量分别为(287.5±96.3) mL、(78.9±42.1) mL，明显多于对照组的(158.2±48.6) mL、(59.2±28.6) mL，差异均有统计学意义(P<0.05)；观察组产妇的先兆子宫破裂、产后出血、产后感染、盆腔黏连的发生率分别为 3.33%、10.83%、10.83%、35.00%、均明显高于对照组的0、3.33%、2.50%、20.00%，差异均有统计学意义(P<0.05)。结论 瘢痕子宫产妇二次剖宫产更容易发生先兆子宫破裂、产后出血、产后感染、盆腔黏连等并发症，孕期及产时需针对上述并发症发生的高危因素，采取对应的预防处理措施，以减少并发症的发生率、预防不良妊娠结局的发生。
      【关键词】 瘢痕子宫；剖宫产；并发症；先兆子宫破裂；妊娠结局
      【中图分类号】 R719.8 【文献标识码】 A 【文章编号】 1003—6350（2018）22—3166—03

A clinical controlled study of scar uterus maternal repeated cesarean section and non-scar cesarean section.
SUNLi, ZHANG Dan, LI Jia. Department of Obstetrics and Gynecology, Liaoning Electric Power Central Hospital, Shenyang110000, Liaoning, CHINA
【Abstract】 Objective To compare the incidence of complication of scar uterus maternal repeated cesarean sec-tion and non-scar cesarean section, and to determine the risk of repeated cesarean section for scar uterus. Methods Onehundred and twenty cases of scar uterus maternal repeated cesarean section were included in the observation group, whowere admitted to the Department of Obstetrics and Gynecology at Liaoning Electric Power Central Hospital during May2016 and May 2018; 120 cases of non-scar cesarean section were taken as the control group. The operation time, intraopera-tive and postpartum hemorrhage, duration of lotion and postoperative complications were compared between the twogroups. Results The operation time and postpartum lochia time in the observation group were (59.4±18.8) minutes and(51.3±17.8) days, respectively, which were significantly longer than (46.2±16.5) minutes and (39.2±14.5) days in the con-trol group; and the volume of intraoperative and postpartum hemorrhage were (287.5±96.3) mL and (78.9±42.1) mL, whichwere significantly higher than (158.2±51.3) mL and (59.2±28.6) mL in the control group (P<0.05). The incidence of threat-ened uterine rupture, postpartum hemorrhage, postpartum infection, and pelvic adhesion in the observation group were3.33% , 10.83% , 10.83% , and 35.00% , respectively, which were significantly higher than the corresponding 0, 3.33% ,2.50%, and 20.00% in the control group, and all the differences were statistically significant (P<0.05). Conclusion Thescar uterus maternal repeated cesarean section is more prone to have complications such as threatened uterine rupture, post-partum hemorrhage, postpartum infection, and pelvic adhesion. During pregnancy and delivery, corresponding preventivemeasures should be taken for the high risk factors of the above complications to reduce the incidence of complications andprevent the occurrence of adverse pregnancy outcomes.
      【Key words】 Scar uterus; Cesarean section; Complications; Threatened uterine rupture; Pregnancy outcome·论 著·doi:10.3969/j.issn.1003-6350.2018.22.018