【摘要】 目的探讨瘢痕子宫行多次剖宫产时最佳切口的选择。方法回顾性分析2013年1月至2014年10月在阿尔及利亚赛义达省妇产医院施行多次剖宫产的543例患者的临床资料。以1cm为等差,根据瘢痕子宫手术切口位置分成4组。136例子宫下段原瘢痕处进入宫腔为A组;135例高于瘢痕1cm处进入宫腔为B组;137例高于瘢痕2cm处进入宫腔为C组;135例高于瘢痕3cm处进入宫腔为D组。对术中出血、手术时间、术后住院时间、新生儿评分、术中术后并发症进行比较分析。结果 C组与其它各组在术中出血、手术时间进行比较,均P=0.000<0.01。与A组在并发症方面比较,P=0.001<0.05。新生儿评分与A组比较,P=0.014<0.05,与D组比较,P=0.002<0.01,差异有统计学意义。结论多次剖宫产子宫切口一般应选择位于子宫下段原切口瘢痕上2cm进入宫腔为宜。更多还原

【Abstract】 Objective To explore the best incision of scar uterus for cases of multiple cesarean section.Methods Clinical data of 543 cases of multiple cesarean section performed during the period of January 2013 to October 2014 in Algeria Saiyida Provincial Maternity Hospital were analyzed retrospectively.Based on 1 cm arithmetic,the cases were divided into four groups according to the operation incision of scar uterus.The incision in group A(136 cases) was at scar uterus,that in group B(135 cases) was 1cm higher than the scar,that in group C(137 cases) was 2cm higher than the scar,and that in group D(135 cases) was 3cm higher than the scar.Four groups were compared in intraoperative bleeding,surgery duration,postoperative hospital stay,neonatal score and intraoperative and postoperative complications.Results Compared with other groups,group C was significantly different in intraoperative bleeding and operation duration(all P = 0.000 <0.01),and it was different from group A in complications(P = 0.001 < 0.05).In neonatal score group C was significantly different from group A(P=0.014<0.05) and group D(P = 0.002 < 0.01).Conclusion The uterine incision for cases of multiple cesarean section should be located at 2cm in the upper part of former scar.更多还原