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目的探讨剖宫产切口愈合不良的发生率及相关危险因素、临床特征、处理及预防措施。方法 2007年1月—2012年9月住院剖宫产共9 564例,切口愈合不良45例,占0.47%,其中出院后7~10 d出现切口愈合不良返院治疗5例,占11.11%。分别为切口脂肪液化12例,切口感染29例,裂开4例。根据患者切口愈合情况将切口愈合不良45例患者作为观察组,随机抽取100例愈合良好者作为对照组。回顾性分析剖宫产产妇的临床资料。计数资料应用χ2检验,P<0.05为差异有统计学意义。结果发生切口愈合不良45例,发生率为0.47%;分别为脂肪液化12例、切口感染29例、裂开4例。经抗感染、清创、充分引流、二期缝合等治疗后均愈合。愈合不良的相关因素:肥胖、术前感染、术前贫血、胎膜早破、未预防应用抗生素、阴道检查过多等。结论多种危险因素影响切口的愈合,应积极处理孕前期、孕期及围术期的各个环节,减少剖宫产术后切口感染。
Objective To investigate the incidence of cesarean section incision healing and related risk factors, clinical features, treatment and preventive measures. Methods From January 2007 to September 2012, 9 564 cesarean sections were hospitalized, and 45 cases were poorly incised wound healing, accounting for 0.47%. Among them, 5 cases (11.11%) had failed back incision healing 7 to 10 days after discharge. Respectively, incision fat liquefaction in 12 cases, incision infection in 29 cases, split in 4 cases. 45 cases of poor incision healing according to the incision healing of patients as the observation group, 100 cases were randomly selected as the control group. Retrospective analysis of cesarean section maternal clinical data. Count data using χ2 test, P <0.05 for the difference was statistically significant. Results incision healing in 45 cases, the incidence was 0.47%; respectively, fat liquefaction in 12 cases, incision infection in 29 cases, split in 4 cases. After anti-infective, debridement, full drainage, two suture healing after healing. Correlated factors of poor healing: obesity, preoperative infection, preoperative anemia, premature rupture of membranes, unpredictable use of antibiotics, vaginal examination and so on. Conclusion A variety of risk factors affect the incision healing, should actively deal with various stages of pregnancy, pregnancy and perioperative period, reduce incision infection after cesarean section.