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目的:探索适合二次剖宫产切口的缝合方法。方法:将120例第2次行剖宫产的孕妇分为两组:对照组40例采用马彦彦新式剖宫产术,不缝合脏壁层腹膜。观察组80例采用改良新式剖宫产术,连续缝合子宫膀胱反折腹膜及腹膜,其中40例不缝合皮下脂肪层,10例缝合皮下脂肪层3~5针,30例间断一起缝合皮下脂肪层。结果:两组术后腹腔粘连以及愈合情况的比较差异有统计意义(P<0.05)。结论:改良新式剖宫产缝合腹膜恢复解剖层次,可以相应地减少腹腔粘连防止脏器损伤;而在缝合皮下脂肪层的方法中,不缝合皮下脂肪层的方法可以更好地减少皮下脂肪层缝合后的局部组织缺血坏死及残留缝线的异物反应,皮下不易出现硬结,且产妇血液处于高凝状态,切口不容易出血,有利于切口愈合。
Objective: To explore the suture method suitable for secondary cesarean section incision. Methods: 120 cases of second cesarean section pregnant women were divided into two groups: the control group of 40 cases of Ma Yanyan new cesarean section, not the dirty parietal peritoneum. In the observation group, 80 cases were treated with modified cesarean section, and the peritoneum and retroperitoneum were continuously sutured. Among them, 40 cases were not sutured with subcutaneous fat layer, 10 cases were sutured with subcutaneous fat layer 3 to 5 pins, 30 cases were interrupted with suturing subcutaneous fat layer . Results: There was significant difference between the two groups in postoperative abdominal adhesions and healing (P <0.05). CONCLUSIONS: The improved cesarean section peritoneal restoration of the anatomical level can reduce the peritoneal adhesions accordingly to prevent organ damage. However, in the method of suturing the subcutaneous fat layer, the methods of not sewing the subcutaneous fat layer can better reduce the suture of the subcutaneous fat layer After the local tissue ischemic necrosis and foreign body residual suture foreign body reaction is not easy to subcutaneous induration, and maternal blood in hypercoagulable state, the incision is not easy to bleeding, is conducive to incision healing.