摘要
目的:探讨瘢痕子宫再妊娠孕妇剖宫产术后盆腹腔粘连的相关因素。方法:回顾性收集本院2016年1月-2020年1月收治的120例瘢痕子宫再次妊娠并行剖宫产终止妊娠产妇临床资料,根据术中探查盆腹腔粘连情况分级,分析两次剖宫产间隔时间、两次剖宫产期间流产清宫次数、宫口开大程度、羊水污染等资料与盆腹腔粘连关系。结果:120例中有61例(粘连组,50.8%)剖宫产术中可见不同程度的盆腹腔粘连,无盆腹腔粘连者为对照组。两次剖宫产间隔时间≤2年(65.6%)发生盆腹腔粘连占比高于间隔时间>2年(34.4%),前次剖宫产宫口开大程度越大,盆腹腔粘连发生率越高,前次剖宫产羊水污染Ⅱ度、Ⅲ度者盆腹腔粘连率高于无羊水污染及Ⅰ度污染者,前次剖宫产医院级别越低盆腹腔粘连率越高,前次剖宫产后并发症粘连组(33.3%)高于对照组(10.2%)(均P<0.05)。结论:前次剖宫产宫口开大程度、羊水污染程度、两次剖宫产间隔时间、前次剖宫产医院级别及剖宫产后并发症均可是盆腹腔粘连发生的相关因素。
Objective:To discuss the factors associated with intra-abdominal and pelvic adhesion of women with scar uterus after cesarean section of prepregnancy.Methods:The clinical data of 120 women with scar uterus after cesarean section of prepregnancy from January 2016 to January 2020 were collected retrospectively.The intra-abdominal and pelvic adhesions was graded based on the exploration during cesarean section.The correlation between the time interval in two cesarean sections,the times of abortion between the two cesarean sections,the times of curettage after abortion between the two cesarean sections,the degree of orifice of uterus opening,or the amniotic fluid pollution of the women and their intraa bdominal and pelvic adhesion was analyzed.Results:Among 120 women,61 women(50.8%)in study group were found different degrees of intra-abdominal and pelvic pelvic adhesion during cesarean section,and other women without intra-abdominal and pelvic pelvic adhesion were in control group.The incidence of intra-abdominal and pelvic adhesion(65.6%)of the women with the interval of the two cesarean sections≤2 years was significantly higher than that(34.4%)of the women with the interval of the two cesarean sections>2 years.The greater the opening degree of orifice of the uterus in the previous cesarean section,the higher the incidence of intra-abdominal and pelvic pelvic adhesion.The incidence of intraabdominal and pelvic adhesion of the women withⅡ-Ⅲamniotic fluid pollution was significantly than that of the women withⅠamniotic fluid pollution or without amniotic fluid pollution.The lower the level of hospital for previous cesarean section,the higher incidence of intra-abdominal and pelvic adhesion.The incidence of intra-abdominal and pelvic adhesion(33.3%)of the women in the study group was significantly higher than that(10.2%)of the women in the control group(all P<0.05).Conclusion:The opening degree of orifice of the uterus,the degree of amniotic fluid pollution,the interval between the two cesarean sections,the hospital level for previous cesarean section,and the complications after previous cesarean section of the women are all the relevant factors of their intra-abdominal and pelvic adhesions occurrence.
作者
王琳
黄巧玲
于胜男
WANG Lin;HUANG Qiaoling;YU Shengnan(Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou,Henan Province,450000)
出处
《中国计划生育学杂志》
2023年第3期641-645,共5页
Chinese Journal of Family Planning
关键词
瘢痕子宫
再次剖宫产
盆腹腔粘连
相关因素
Scar uterus
Subseguent Cesarean section
Intra-abdominal and pelvic adhesion
Correlation factor
