摘要
目的:观察经皮神经电刺激(transcutaneous electrical nerve stimulation,TENS)预防剖宫产术后子宫切口缺损(previous cesarean scar defect,PCSD)形成的效果。方法:选择2021年2月至2021年11月于江苏大学第四附属医院产科行剖宫产分娩的初产妇151例,随机分为体尾组(n=51)、宫角+体尾组(n=50)和对照组(n=50);对照组行常规产后护理,体尾组于剖宫产术后6 h采用2个电极片分别贴至宫体的体表投影部位和骶尾部,宫角+体尾组于剖宫产术后6 h采用4个电极片分别贴至双侧宫角体表投影、宫体体表投影和骶尾部,行TENS治疗,20 min/次,1次/d,连续3 d;3组分别于产后6周和6个月行阴道超声检查,比较产后6周和6个月子宫大小、憩室形成数量及憩室大小。结果:3组间产妇产后6周和6个月时子宫长度、宽度及厚度比较差异无统计学意义(P>0.05),但6个月时子宫均明显小于产后6周(P均<0.01);与对照组相比,体尾组和宫角+体尾组产后6周、6个月PCSD形成率均明显降低(P均<0.05),但体尾组和宫角+体尾组之间PCSD形成率比较差异无统计学意义(P>0.05)。3组PCSD形成者产后6周与6个月憩室宽度、深度及残存肌层厚度比较差异均无统计学意义(P>0.05)。结论:在剖宫产术后6 h行TENS可显著降低PCSD形成,采用2个电极片或4个电极片通路对降低PCSD形成效果无明显差异。
Objective:To observe the effect of transcutaneous electrical nerve stimulation(TENS)on preventing the formation of previous cesarean scar defect(PCSD).Methods:A total of 151 primary parturients who delivered with cesarean section in the Fourth Affiliated Hospital of Jiangsu University from February 2021 to November 2021 were randomly divided into uterine body sacral tail group(n=51),uterine horn+uterine body sacral tail group(n=50)and control group(n=50).The control group received routine postpartum care;2 electrodes were applied to the projection site of uterine body surface and the sacral tail 6 hours after cesarean section in the uterine body sacral tail group,and 4 electrodes were applied to the body surface projection of bilateral uterine horns,the projection site of uterine body surface and the sacral tail 6 hours after cesarean section in the uterine horn+uterine body sacral tail group,and TENS treatment was performed,20 min per time,once per day,for 3 consecutive days.The uterine size,number of diverticulum formation and size of diverticulum of the three groups were compared at 6 weeks and 6 months after delivery.Results:There was no significant difference in uterine size(uterine length,width and thickness)among the three groups at 6 weeks and 6 months postpartum(P>0.05),but the uterine size of the three groups at 6 months postpartum was significantly smaller than that at 6 weeks postpartum(P<0.01).At 6 weeks and 6 months postpartum,the PCSD formation rate in the uterine body sacral tail group and uterine horn+uterine body sacral tail group was significantly lower than that in the control group(P<0.05),but there was no statistical significance in the PCSD formation rate between the uterine body sacral tail group and the uterine horn+uterine body sacral tail group(P>0.05).There were no significant differences in the changes of diverticulum(diverticulum width,depth and remaining muscle thickness)among the 3 groups at 6 weeks and 6 months postpartum in PCSD patients(P>0.05).Conclusion:The application of TENS 6 hours after cesarean section significantly reduced the formation of PCSD,and there was no significant difference in the effect of reducing the formation of PCSD by using two electrodes or four electrodes.
作者
陈伟鸿
王轶群
李卫
CHEN Weihong;WANG Yiqun;LI Wei(Department of Gynecology,the Fourth Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)
出处
《江苏大学学报（医学版）》
CAS
2024年第3期260-265,共6页
Journal of Jiangsu University：Medicine Edition
基金
江苏省妇幼健康科研项目(F202143)
镇江市社会发展项目(SH2021042)。
关键词
经皮神经电刺激
剖宫产术后子宫切口缺损
剖宫产
憩室
transcutaneous electrical nerve stimulation
previous cesarean scar defect
cesarean delivery
diverticulum
