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目的:探究应用子宫下段剖宫产术(Lower uterine cesarean section,LUCS)和斯塔克剖宫产术(Stark cesarean section,SCS)于疤痕子宫再次妊娠的效果。方法:选择2012年3月至2013年10月在我院再次妊娠的疤痕子宫产妇187例,观察组95例应用LUCS,对照组92例应用SCS。观察对比两组病患手术指标和术后并发症以及新生儿Apgar评分。结果:两组新生儿均成功存活。观察组的手术出血量(293±72)m L和住院时间(4.1±0.53)d,少于对照组(P均为0.00),产后症状表现更好。观察组在产后出血、产后发热以及产褥感染中的比例均低于对照组(P=0.02;P=0.01;P=0.04)。而且观察组未出现子宫破裂,盆腔粘连发生率为3.16%(3/95),少于对照组的13.04%(12/92)(P=0.04,P=0.01);观察组新生儿Apgar评分更高,差异均有统计学意义(P=0.00)。结论:应用LUCS于疤痕子宫再次妊娠的可行性更强,不仅减少产妇术后并发症的发生率,也提高了新生儿Apgar评分,值得临床推荐。
Objective: To explore the effect of using the lower uterine cesarean section (LUCS) and the Stark cesarean section (SCS) on the second pregnancy of the scar. Methods: A total of 187 cases of uterine scar pregnancy in our hospital from March 2012 to October 2013 were selected. 95 cases in the observation group were treated with LUCS and 92 cases in the control group were treated with SCS. Observe and compare the operation indexes and postoperative complications of two groups of patients and neonatal Apgar score. Results: Both groups of newborns survived successfully. The operative blood loss (293 ± 72) m L and hospital stay (4.1 ± 0.53) days in the observation group were less than those in the control group (P = 0.00). Postpartum symptoms were better. The proportion of observation group in postpartum hemorrhage, postpartum fever and puerperal infection were lower than those in control group (P = 0.02; P = 0.01; P = 0.04). The incidence of pelvic adhesions was 3.16% (3/95) in the observation group and 13.04% (12/92) in the control group (P = 0.04, P = 0.01). The Apgar score in the observation group was more High, the difference was statistically significant (P = 0.00). Conclusion: It is more feasible to use LUCS to re-pregnancy in scar uterus, which not only reduces the incidence of postoperative complications but also improves Apgar score in neonates, which is worthy of clinical recommendation.