摘要
目的探讨剖宫产术后子宫切口憩室形成的影响因素。方法回顾性分析2017年1月至2018年1月在首都医科大学附属北京妇产医院行剖宫产术后半年门诊复查的530例产妇的临床资料,根据是否发生子宫切口憩室分为憩室形成组(n=37)与无憩室形成组(n=493),将两组产妇各项临床资料进行单因素分析,对单因素分析存在明显差异的指标进行非条件logistic多元逐步回归分析。结果单因素分析显示,产妇肥胖(χ~2=4.58,P=0.03)、产程延长(χ~2=10.97,P=0.00)、择期手术(χ~2=4.49,P=0.03)、多胎(胎数≥2)妊娠(χ~2=3.95,P=0.04)、子宫后位(χ~2=12.59,P=0.00)、剖宫产≥2次(χ~2=4.70,P=0.03)、子宫切口单层缝合(χ~2=4.58,P=0.03)、胎膜早破(χ~2=13.67,P=0.00)、妊娠期糖尿病(χ~2=5.62,P=0.02)均与剖宫产术后子宫切口憩室形成有关。多因素的logistic回归分析显示,剖宫产次数≥2次、子宫后位、产程延长及胎膜早破均是子宫切口憩室形成的独立危险因素。结论剖宫产次数≥2次、子宫后位、产程延长及胎膜早破是剖宫产术后子宫切口憩室形成的独立危险因素,应加强此类产妇的手术风险监控,及时采取防治措施,降低子宫切口憩室形成风险。
Objective To investigate the factors cesarean incision diverticula formation.Method The clinical data of 530 pregnant women who underwent cesarean section in our hospital from January 2017 to January 2018 were analyzed retrospectively to understand the occurrence of uterine incision diverticulum.In 530 cases of parturient,there were 37 cases of uterine incision diverticulum.According to whether diverticulum was formed,it was divided into two groups:diverticulum formation group(n=37)and non-diverticulum formation group(n=493).The clinical data of the two groups were studied by means of univariate analysis,and the indexes with significant differences in univariate analysis were given non-conditional logistic multiple stepwise regression analysis.Result Maternal obesity(χ^2=4.58,P=0.03),prolonged labor process(χ^2=10.97,P=0.00),elective surgery(χ^2=4.49,P=0.03),multiple pregnancies(≥2)(χ^2=3.95,P=0.04),posterior uterine position(χ^2=12.59,P=0.00),cesarean section≥2 times(χ^2=4.70,P=0.03),premature rupture of membranes(χ^2=13.67,P=0.00),gestational diabetes mellitus(χ^2=5.62,P=0.02),single-layer closure(χ^2=4.58,P=0.03)were all the single factors affecting the formation of uterine incision diverticulum.Multivariate logistic regression analysis showed that cesarean section≥2 times,posterior uterine position,prolonged labor process and premature rupture of membranes were all independent risk factors for the formation of diverticulum in uterine incision.Conclusion Multivariate logistic regression analysis showed that cesarean section≥2 times,posterior uterine position,prolonged labor process and premature rupture of membranes were independent risk factors for the formation of diverticulum in uterine incision.It is necessary to strengthen the monitoring of surgical risk and take preventive measures in time to reduce the risk of diverticulum formation in uterine incision.
作者
邢宇
王小新
王欣
XING Yu;WANG Xiao-xin;WANG Xin(Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026 China)
出处
《中国医刊》
CAS
2019年第5期529-532,共4页
Chinese Journal of Medicine
关键词
剖宫产
子宫切口憩室
影响因素
Cesarean section
Uterine incision diverticulum
Influencing factors
