子宫下段切缘缝合方式对子宫康复及二次妊娠子宫破裂的影响

任燕1，李艳萍2

（1. 西安市临潼区人民医院妇产科，陕西 西安，710600；2.陕西省神木市医院妇产科，陕西 榆林，719399）

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摘要：

目的 探讨子宫下段切缘缝合方式对子宫康复及二次妊娠子宫破裂的影响。方法 选取在我院行初次剖宫产分娩后再 次在我院进行住院分娩的产妇98 例，按初次剖宫产缝合方式分为观察组（子宫下段切缘双层缝合，55 例）和对照组（子宫下 段切缘单层缝合，43 例）。比较两组子宫瘢痕厚度、先兆子宫破裂及盆腔粘连发生情况。结果 观察组瘢痕子宫下段厚度3≤ h≤5 mm 占比（94.55%）高于对照组（76.74%）（P<0.05）；观察组盆腔无粘连占比为67.27%，高于对照组的46.51%（P<0.05）；观察组先兆子宫破裂发生率（3.64%）明显低于对照组（18.60%）（P<0.05）。结论 子宫下段切缘缝合方式影响剖宫产后再次妊 娠孕妇的子宫康复及二次妊娠子宫破裂情况，双层缝合可促进瘢痕子宫下段厚度增加，减少腹腔粘连及先兆子宫破裂发生。

关键词：子宫下段切缘缝合；子宫康复；二次妊娠子宫破裂；剖宫产

中图分类号：R719.8文献标志码：A文章编号：2096-1413(2017)35-0117-02

Effect of suture methods of lower uterine segment margin on uterine rehabilitation and second pregnant uterine rupture
REN Yan 1, LI Yan-ping 2
(1. Obstetrics and Gynaecology Department, People``s Hospital of Lintong District in Xi``an, Xi``an 710600;
2. Obstetrics and Gynaecology Department, Shenmu Hospital, YuLin 719399, China)

ABSTRACT: Objective To investigate the effect of suture methods of lower uterine segment margin on uterine rehabilitation and second pregnant uterine rupture. Methods Ninety-eight pregnant women who received initial cesarean section in our hospital were selected, and divided into observation group (two-layered suture of lower uterine segment margin, 55 cases) and control group (single-layer suture of lower uterine segment margin, 43 cases) according to suture methods of first cesarean section. The thickness of cesarean scar, threatened uterine rupture and pelvic adhesion were compared between the two groups. Results In the observation group, the proportion of lower scar uterus thickness with 3≤h≤5 mm (94.55%) was significantly higher than that in the control group (76.74%) (P<0.05); the proportion of no pelvic adhesions was 67.27%, which was significantly higher than 46.51% in the control group (P<0.05); the incidence rate of threatened uterine rupture (3.64%) was significantly lower than that in the control group (18.60%) (P<0.05). Conclusion The suture methods of lower uterine segment margin influences the uterine rehabilitation and second pregnant uterine rupture of women with second pregnancy. Two-layered suture can promote the increasing of lower segment thickness of scarred uterus, and reduce abdominal adhesion and threatened uterine rupture.
KEYWORDS: suture of lower uterine segment margin; uterine rehabilitation; second pregnant uterine rupture; cesarean section

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