CAJ | 학술논문

目的：分析剖宫产产妇并发盆腔粘连的影响因素。方法回顾性分析剖宫产并发盆腔粘连46例产妇的临床资料，对盆腔粘连相关因素进行单因素和多因素logistic回归分析。结果剖宫产后产妇盆腔粘连的发生率30.67%，其中约70%患者的粘连程度较轻，黏膜易分离；单因素分析结果显示年龄、孕次、距离剖宫产间隔年限不是剖宫产术后盆腔粘连风险因素，而手术方式、术中几丁糖等的应用、“W”形腹膜层缝合的应用与盆腔粘连呈显著相关性（P<0.05）；多因素分析表明，手术方式、术中是否选用几丁糖、是否“W”形腹膜层缝合的应用为影响盆腔粘连发生的危险因素。结论采用传统子宫下段剖宫产术、应用几丁糖和“W”形腹膜层缝合能有效降低盆腔粘连的发生。
목적：분석부궁산산부병발분강점련적영향인소。방법회고성분석부궁산병발분강점련46례산부적림상자료，대분강점련상관인소진행단인소화다인소logistic회귀분석。결과부궁산후산부분강점련적발생솔30.67%，기중약70%환자적점련정도교경，점막역분리；단인소분석결과현시년령、잉차、거리부궁산간격년한불시부궁산술후분강점련풍험인소，이수술방식、술중궤정당등적응용、“W”형복막층봉합적응용여분강점련정현저상관성（P<0.05）；다인소분석표명，수술방식、술중시부선용궤정당、시부“W”형복막층봉합적응용위영향분강점련발생적위험인소。결론채용전통자궁하단부궁산술、응용궤정당화“W”형복막층봉합능유효강저분강점련적발생。
ObjectiveTo analysis the affecting factors of pelvic adhesion for 46 cases puerpera with cesarean section.MethodsRetrospective analysis the informations of puerpera with cesarean section from June 2012 to September 2013 was performed,then the pelvic adhesions related factors were taken into univariate and multivariate logistic regression analysis.ResultsThe incidence of pelvic adhesion after cesarean section was 30.67%, which approximately 70% of patients with a lesser degree of adhesion,the mucosal could be easily separated. Univariate regression analysis showed that age,gravidity and interval from cesarean section were not the affect factors for pelvic adhesion after cesarean section,but surgical approach,the application of Chitosan and "W"-shaped suture the peritoneum layer application were significantly correlated to pelvic adhesion(P<0.05). Multivariate logistic regression analysis showed that surgical approach,the application of Chitosan and "W"-shaped suture the peritoneum layer application were risk factors for pelvic adhesion.ConclusionUsing the traditional lower uterine segment cesarean section,and application of Chitosan and "W"-shaped suture the peritoneum layer application could effectively reduce the incidence of pelvic adhesions.