剖宫产子宫切口缝合方法与再次剖宫产切口厚度的相关性研究

摘要

目的：探究剖宫产子宫切口缝合方法与再次剖宫产切口厚度的相关性。方法：选取2011年1月～2014年1月于我院进行就诊的400例再次剖宫产术产妇作为研究对象，其中，215例在初次剖宫产术中采用单层缝合方法作为单层缝合组，185例在初次剖宫产术中采用双层缝合方法作为双层缝合组。对再次剖宫产时产妇手术时的各项指标进行比较。结果：对比两组产妇原切口部位子宫肌层厚度情况发现，单层缝合组产妇子宫下端肌层厚度整体低于双层缝合组。两组患者再次剖宫产手术过程中，单层缝合组手术时间显著短于双层缝合组，且术中出血量较少；但腹腔粘连水平单层缝合组产妇要明显高于双层缝合组。术后双层缝合组切口愈合不良水平低于单层缝合组（P＜0.05）；缝线吸收率以及切口感染率两组比较结果不具有差异性（P＞0.05）；术后肛门排气时间双层缝合组低于单层缝合组（P＜0.05）。结论：剖宫产子宫切口双层缝合方法有利于提高瘢痕子宫孕妇二次剖宫产分娩率，减少瘢痕子宫孕妇孕期并发症的发生，缩短住院时间，降低早产儿的发生率。对医院整体阴道分娩率的提高有极大的促进作用。%Objective: To explore the correlation of the uterine incision cesarean section on methods and again cesarean section thickness.Methods:400 cases were selected in our hospital for treatment of maternal cesarean again as research subjects in January 2011 to January 2014 period,of which 215 cases were given single-suture method in the initial cesarean section as a single layer suture groups,185 cases were given double-stitched double-stitched group as a method in the initial cesarean section.Maternal uterine myometrium during surgery under section thickness,The comparison of the indexes of the maternal operation when the cesarean section again.Results:Compared with the two groups of mothers original incision site myometrium thickness case found that the maternal womb single suture group as a whole is less than double the thickness of the lower muscular suture group.Two groups of patients again during cesarean section,single suture operative time was significantly shorter than double suture group,and less blood loss; but the level of abdominal adhesions single suture group was significantly higher than the maternal double suture group.Postoperative wound healing double suture group were lower than single suture group(P<0.05); sutures and wound infection absorption rate between the two groups do not have the results of difference(P>0.05); postoperative flatus double stitching group than single-suture group(P<0.05).Conclusion:Cesarean uterine incision double suture help improve maternal uterine scar secondary cesarean delivery rate,reduce the incidence of complications during pregnancy uterine scar,shorter hospital stay,reduce the incidence of premature children.To improve the hospital's overall rate of vaginal delivery has great role in promoting.