目的　比较剖宫产手术中子宫切口腹腔内与腹腔外缝合对产妇的影响。方法　采用随机对照试验方法 ,选择 2 2 0例单胎足月妊娠且无严重妊娠合并症和并发症的妇女 ,随机分配到两组 ,试验组 112例 ,对照组 10 8例。试验组在缝合子宫切口的过程中将子宫置于腹腔外 ,对照组则将子宫保留在腹腔内。观察手术前后血红蛋白含量的变化、围手术期血流动力学和动脉血氧饱和度的变化、术中术后出血量、手术时间、胃肠道反应以及术后胃肠功能恢复时间、术后发热和疼痛和其它手术并发症发生情况。数据分析采用SPSS 11 0软件。结果　两组术后血红蛋白含量均较术前下降 ,手术前后下降程度的比较显示腹腔内缝合组显著高于腹腔外缝合组(t=- 2 90 2 ,P =0 0 0 4 )。两组产妇间比较 ,围手术期的舒张压、脉搏和动脉血氧饱和度无显著性差异。两组产妇术前脉搏都较缝合子宫时及术后快 ,差异有统计学意义 (P <0 0 5 )。试验组收缩压在术前、缝合子宫时和术后三个时间点均低于对照组 (F =5 2 4 6 ,P =0 0 2 2 ) ,但组内 3个时间点比较没有统计学差异。手术时间、术中出血量、术中胃肠道症状和术后发热以及术后 3d疼痛评分上也无统计学差异。术后肛门开始排气时间腹腔内缝合组较试验组明显提前 (t=5 5 6 7,P =0 0 0 0 )。研究 Objective To compare the effect of intrauterine and extraperitoneal sutures on the mothers during cesarean section. Methods A randomized controlled trial was conducted. Two hundred and twenty-two singleton pregnancies without severe pregnancy complications and complications were randomly assigned to two groups, 112 in trial group and 108 in control group. The experimental group placed the uterus outside the abdominal cavity during suturing of the uterine incision while the control group kept the uterus in the abdominal cavity. Changes of hemoglobin before and after surgery, perioperative hemodynamics and arterial oxygen saturation changes, intraoperative and postoperative bleeding volume, operation time, gastrointestinal reactions and postoperative gastrointestinal function recovery time, postoperative fever And pain and other complications of surgery. Data analysis using SPSS 11 0 software. Results The postoperative hemoglobin contents of both groups decreased compared with that before operation. The comparison of the degree of decrease before and after operation showed that the intra-abdominal suture group was significantly higher than that of the extraperitoneal suture group (t = -2902, P = 0.004). Comparing the two groups of maternal, perioperative diastolic blood pressure, pulse and arterial oxygen saturation no significant difference. The two groups of maternal preoperative pulse than suture the uterus and postoperative fast, the difference was statistically significant (P <0 05). The systolic blood pressure of the experimental group was lower than that of the control group (F = 5246, P = 0 0 2 2) at the time of preoperative, sutured uterus and postoperative, but there was no statistical difference at 3 time points difference. The operation time, intraoperative blood loss, intraoperative gastrointestinal symptoms and postoperative fever and postoperative 3d pain scores were also not statistically different. Postoperative anus began to exhaust the intraperitoneal suture group was significantly earlier than the experimental group (t = 5 567, P = 0 0 0 0). the study