CAJ | 학술논문

目的：探索适合二次剖宫产切口的缝合方法。方法：将120例第2次行剖宫产的孕妇分为两组：对照组40例采用马彦彦新式剖宫产术,不缝合脏壁层腹膜。观察组80例采用改良新式剖宫产术,连续缝合子宫膀胱反折腹膜及腹膜,其中40例不缝合皮下脂肪层,10例缝合皮下脂肪层3~5针,30例间断一起缝合皮下脂肪层。结果：两组术后腹腔粘连以及愈合情况的比较差异有统计意义( P<0.05)。结论：改良新式剖宫产缝合腹膜恢复解剖层次,可以相应地减少腹腔粘连防止脏器损伤；而在缝合皮下脂肪层的方法中,不缝合皮下脂肪层的方法可以更好地减少皮下脂肪层缝合后的局部组织缺血坏死及残留缝线的异物反应,皮下不易出现硬结,且产妇血液处于高凝状态,切口不容易出血,有利于切口愈合。
목적：탐색괄합이차부궁산절구적봉합방법。방법：장120례제2차행부궁산적잉부분위량조：대조조40례채용마언언신식부궁산술,불봉합장벽층복막。관찰조80례채용개량신식부궁산술,련속봉합자궁방광반절복막급복막,기중40례불봉합피하지방층,10례봉합피하지방층3~5침,30례간단일기봉합피하지방층。결과：량조술후복강점련이급유합정황적비교차이유통계의의( P<0.05)。결론：개량신식부궁산봉합복막회복해부층차,가이상응지감소복강점련방지장기손상；이재봉합피하지방층적방법중,불봉합피하지방층적방법가이경호지감소피하지방층봉합후적국부조직결혈배사급잔류봉선적이물반응,피하불역출현경결,차산부혈액처우고응상태,절구불용역출혈,유리우절구유합。
Objective:To explore the appropriate suture method for the incision of repeated cesarean section. Methods:120 pregnant women underwent repeated cesarean section were divided into two groups: 40 cases in the control group accepted Yanyan Ma new-style caesarean section without suturing the splanchnopleure peritoneum. 80 cases in the observation group adopted improved new-style caesarean section with continuously suturing bladder-uterine folded peritoneum and peritoneum, including 40 cases without suturing subcutaneous fat layer, 10 cases with suturing subcutaneous fat layer by 3 to 5 needles, 30 cases with discontinuously suturing subcutaneous fat layer together. Results: There was statistical significance between postoperative abdominal adhesions and healing condition. Conclusion:Adopting improved new-style caesarean section for the recovery of anatomical level could reduce postoperative abdominal adhesions accordingly to prevent organ damage. However, the method without suturing subcutaneous fat layer can better reduce ischemia and necrosis of local tissues and foreign body reaction of residual suture, and avoid subcutaneous calluses. Moreover, the incisions seldom bleed when using the method, which helps the incision healing, for puerperas with blood hypercoagulability.