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目的:探讨不同剖宫产术式对二次剖宫产影响。方法:选择因瘢痕子宫足月妊娠行再次剖宫产病例87例,年龄24～44岁,平均31岁;孕周37～41周。其中既往采用改良新式剖宫产史者31例,为观察组;新式剖宫产史者30例,为对照A组;下腹纵切口子宫下段剖宫产史者26例,为对照B组。分析第二次剖宫产手术开始至胎儿娩出时间(T1)手术总时间(T2)及术中出血量、腹腔粘连情况。结果:观察组进腹腔时间稍长于纵切口,但手术总时间短、切口美容、粘连发生率低,与对照1组及对照2组比较差异显著,有统计学意义。结论:对很有可能二次开腹手术病人,选择下腹纵切口可能为明智选择,有利于二次手术操作,减少手术创伤。而美容切口-腹壁横切口永然是剖宫产患者喜爱手术切口,笔者建议采用改良新式剖宫产。它既吸收新式剖宫产的优点,又减少了术后粘连发生,值得推广运用。
Objective: To investigate the effect of different caesarean section on secondary cesarean section. Methods: A total of 87 cases of cesarean section due to full-term scar pregnancy were selected, aged from 24 to 44 years (average 31 years old) and gestational age from 37 to 41 weeks. In the past, 31 cases were used to improve the history of new cesarean section, the observation group; 30 cases of new cesarean section, control group A; lower abdominal longitudinal incision cesarean section in 26 cases, control B group. Analysis of the second caesarean section from the beginning of fetal operation to the time of delivery (T1) total operation time (T2) and intraoperative blood loss, abdominal adhesions. Results: The abdominal cavity time of the observation group was slightly longer than that of the longitudinal incision, but the total operation time was short, the incision beauty and the incidence of adhesions were low. Compared with the control group 1 and the control group 2, the difference was significant and statistically significant. CONCLUSIONS: For patients who are most likely to have open surgery in the second laparotomy, the choice of a longitudinal incision in the lower abdomen may be a wise choice, which is good for secondary surgical procedures and reduces surgical trauma. The beauty incision - abdominal transverse incision is always loved by patients with cesarean surgical incision, I suggest the use of improved cesarean section. It not only absorbs the advantages of new cesarean section, but also reduces the occurrence of postoperative adhesions, it is worth to promote the use of.