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目的探讨腹壁纵横切口对再次剖宫产的影响。方法 2000例行再次剖宫产术患者,根据前次手术腹壁切口将其分为两组,每组1000例,其中前次手术行腹壁纵切口子宫下段剖宫产术为A组,前次手术行腹壁横切口新式剖宫产术为B组,比较腹壁纵横切口再次手术的开腹时间、总时间、术中出血量、盆腹腔粘连、胎儿娩出困难及新生儿窒息发生情况。结果和B组比较,A组的开腹时间及总时间均较短,术中出血量较少,盆腹腔粘连、胎儿娩出困难及新生儿窒息例数较低,差异均具有统计学意义(P<0.05)。结论腹壁横切口新式剖宫产术具有切口瘢痕纤细美观的优点,但盆腹腔粘连严重,胎儿娩出困难,新生儿窒息率增加,对可能需要再次剖宫产的孕妇,首次剖宫产术选择腹壁纵切口子宫下段剖宫产术不失为一种明智的选择。
Objective To investigate the effect of abdominal transverse incision on cesarean section. Methods A total of 2000 patients undergoing cesarean section were divided into two groups according to the previous abdominal incision. Each group had 1000 cases. Among them, the former underwent abdominal cesarean section with abdominal cesarean section as group A, The new cesarean section was performed in group B with transverse incision of abdomen. Comparisons of laparotomy, total time, intraoperative blood loss, pelvic and abdominal adhesions, fetal birthing difficulties and neonatal asphyxia were compared. Results Compared with group B, group A had shorter laparotomy and total time, less blood loss, abdominal pelvic adhesions, difficult delivery and neonatal asphyxia, the difference was statistically significant (P <0.05). Conclusions The new cesarean section with abdominal transverse incision has the advantages of slim and beautiful incision scar. However, pelvic adhesions are serious, the fetus is difficult to deliver and the rate of neonatal asphyxia increases. For pregnant women who may need cesarean section again, the first cesarean section chooses the abdominal wall Longitudinal incision of the lower uterine segment cesarean section after all, a wise choice.