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目的分析改良新式剖宫产术后再次行开腹手术的临床特点。方法选取2012年2月至2013年7月就诊的有新式剖宫产术史和改良新式剖宫产术史且需要再次进行开腹手术的女性患者392例,有新式剖宫产术史患者196例为对照组,有改良新式剖宫产术史患者196例为实验组;对照组再次行新式剖宫产术治疗,实验组再次行改良新式剖宫产术治疗;记录患者开腹时间、开腹出血量,和腹腔粘连、筋膜下血肿和产褥病和伤口脂肪液化的发生情况。结果实验组患者开腹时间、开腹出血量均明显低于对照组(P均<0.01)。实验组患者腹腔粘连、筋膜下血肿和产褥病发生率明显低于对照组(P<0.01或P<0.05);实验组患者伤口脂肪液化发生率也低于对照组,但差异无统计学意义(P>0.05)。结论采取改良新式剖宫产术后再次行开腹手术具有开腹时间短、出血量小及腹腔粘连率、筋膜下血肿率、产褥病率和伤口脂肪液化低等优势,具有重要临床价值。
Objective To analyze the clinical features of open celiotomy after new cesarean section. Methods A total of 392 female patients with a history of new cesarean section and a history of new cesarean section who underwent open surgery again from February 2012 to July 2013 were selected. Patients with a history of new cesarean section 196 For the control group, there are 196 patients with improved history of new cesarean section as the experimental group; the control group again underwent new cesarean section treatment, the experimental group again to improve the new cesarean section treatment; record the patient laparotomy time, open Abdominal bleeding, and abdominal adhesions, subfascial hematoma and puerperal disease and wound liquefaction occurred. Results In the experimental group, the open time and open abdominal bleeding were significantly lower than those in the control group (all P <0.01). The incidence of peritoneal adhesions, subcapsular hematomas and putridges in the experimental group was significantly lower than that in the control group (P <0.01 or P <0.05). The incidence of fat liquefaction in the experimental group was also lower than that in the control group, but the difference was not statistically significant Significance (P> 0.05). Conclusion Reoperation of open cesarean section after modified cesarean section has the advantages of short open time, small amount of bleeding, high rate of peritoneal adhesions, subfascial hematoma, low rate of puerperal morbidity and low liquefaction of wounds, which has important clinical value .