剖宫产术后早期子宫切口缺陷的超声观察及相关因素分析

doi:10.6040/j.issn.1671-7554.0.2015.924

摘要/Abstract

摘要： 目的观察经阴道超声剖宫产术后子宫切口缺陷的早期变化,分析其形成的危险因素。方法选择2013年9月至2015年6月行剖宫产,且产后6周、3个月、6个月均行经阴道超声检查的181例产妇为研究对象,根据观察结果分为切口愈合良好组(142例)及切口缺陷组(39例),分析切口缺陷组产后不同时期的切口变化及其形成的危险因素。结果与切口愈合良好组比较,切口缺陷组产妇产后6个月剖宫产切口缺陷长度较产后6周缩短(P<0.05);非条件Logistic回归结果显示,剖宫产次数增多、术者低年资、术后发生感染、子宫后位、切口接近宫颈内口是子宫瘢痕愈合不良的危险因素。结论随着产后时间延长,剖宫产切口缺陷长度缩短;多次剖宫产、产褥期感染、后位子宫、切口位置低及术者经验不足是形成子宫切口缺陷的危险因素,增加了子宫瘢痕愈合不良的风险。

关键词: 剖宫产, 危险因素, Logistic回归, 阴道超声, 子宫切口缺陷

Abstract: Objective To observe the early changes of uterine incision defect after cesarean section by transvaginal ultrasonography and to analyze the risk factors. Methods A total of 181 maternal cases receiving cesarean section during Sept. 2013 and June 2015, who were examined by transvaginal ultrasound 6 weeks, 3 months, and 6 months postpartum, were divided into 2 groups according to the healing of the incision:good healing group(n=142)and incision defect group(n=39). The changes of the incision in different postpartum periods were observed and the risk factors were analyzed. Results The length of incision 6 months postpartum was shorter than that 6 weeks postpartum(P<0.05). Non-conditional logistic regression analysis showed that an increase in the number of cesarean section, surgeon with low seniority, postoperative infection, posterior uterine and incision close to the cervix were risk factors of incision defect. Conclusion The length of cesarean incision defect shortens as time goes on. Repeated cesarean section, puerperal infection, retroflexed uterine, low-cut position and inexperienced surgeon are risk factors for uterine incision defects, which increase the abnormal healing of uterine scar.

Key words: Cesarean section, Logistic regression, Uterine incision defect, Transvaginal ultrasound, Risk factors

中图分类号:

R445.1

王艺桦,马琳,阚艳敏,王文韬. 剖宫产术后早期子宫切口缺陷的超声观察及相关因素分析[J]. 山东大学学报（医学版）, 2016, 54(5): 39-44.

WANG Yihua, MA Lin, KAN Yanmin, WANG Wentao. Early ultrasound observation of uterine incision defect after cesarean section and analysis of related factors[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 39-44.

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