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目的比较下腹壁纵切口与Pfannentiel式切口在二次剖宫产术切口愈合、腹腔粘连、手术时间及术中出血等情况。方法采用回顾性分析的方法,对二次剖宫产孕妇的术中各项情况进行比较。其中A组为下腹壁纵切口75例,B组为Pfannentiel式切口75例。比较两组孕妇在二次剖宫产术中腹壁切口愈合情况、腹腔粘连、术中出血及手术时间等情况。结果①腹壁切口愈合良好,瘢痕纤细:A组29.3%(22/75),B组74.7%(56/75);②腹腔粘连:A组重度粘连4%(3/75),B组为4%(3/75);③二次手术术中出血量:A组(238±76)ml,B组(248±93)ml;④二次剖宫产开始至胎儿娩出时间:A组(6±3)min,B组(10±3)min;⑤二次剖宫产总时间:A组(37±18)min,B组(46±16)min。腹壁切口愈合方面B组明显优于A组,两组比较差异有统计学意义(P<0.05);二次剖宫产手术开腹时间及总时间上A组明显快于B组,两组比较差异有统计学意义(P<0.05);腹腔粘连及术中出血量上两组比较,差异无统计学意义(P>0.05)。结论下腹壁纵切口虽然在切口愈合方面逊于Pfannentiel式剖宫产,但纵切口在二次剖宫产的开腹时间及手术总时间方面均短于Pfannentiel切口式,且其腹腔粘连率的发生及术中出血量与Pfannentiel式相比,差异无统计学意义。二次剖宫产的孕妇选择下腹纵切口不失为一种更理想的选择。
Objective To compare the incision healing of inferior cesarean section, peritoneal adhesions, operation time and intraoperative bleeding of inferior abdominal wall longitudinal incision and Pfannentiel incision. Methods Retrospective analysis of the method of secondary cesarean section of pregnant women during the operation were compared. A group of 75 cases of lower abdominal wall longitudinal incision, B group Pfannentiel incision in 75 cases. The two groups of pregnant women in the second cesarean section incision healing, abdominal adhesions, intraoperative bleeding and operation time and so on. Results (1) The incision of the abdominal wall was healed well, the stenosis of the scar was 29.3% (22/75) in group A and 74.7% (56/75) in group B. ② The abdominal adhesions were 4% (3/75) in group A and 4 % (3/75); ③ The amount of bleeding during secondary surgery was 238 ± 76 in group A and 248 ± 93 in group B; ± 3) min in group B (10 ± 3) min. The total time of second cesarean section was 37 ± 18 min in group A and 46 ± 16 min in group B. In the abdominal incision healing group B was significantly better than the A group, the difference between the two groups was statistically significant (P <0.05); second cesarean section laparotomy time and total time on the A group was significantly faster than the B group, the two groups compared The difference was statistically significant (P <0.05). There was no significant difference between the two groups in peritoneal adhesion and intraoperative blood loss (P> 0.05). Conclusions The inferior abdominal wall longitudinal incision is inferior to Pfannentiel cesarean section in wound healing, but the longitudinal incision is shorter than Pfannentiel incision in the second cesarean section in laparotomy and total operative time, and the incidence of abdominal adhesion is There was no significant difference in the amount of bleeding during surgery compared with Pfannentiel’s type. Second cesarean section of pregnant women choose abdominal longitudinal incision after all, a more ideal choice.