剖宮產(chǎn)術(shù)后再次妊娠時(shí)限與子宮下段肌層厚度的關(guān)系研究

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【摘要】目的：探討剖宮產(chǎn)術(shù)后再次妊娠時(shí)限與子宮下段肌層厚度的關(guān)系研究。方法：選擇我院2012年1月至2014年1月收治的80例剖宮產(chǎn)術(shù)后再次妊娠患者為研究對(duì)象，通過(guò)剖宮產(chǎn)后至再次妊娠時(shí)限的不同分為A組19例（間隔時(shí)限≤3年），B組26例（間隔時(shí)限3～6年），C組20例（間隔時(shí)限6～9年），D組15例（間隔時(shí)限>9年），分析比較各組患者子宮下段肌層厚度值和陰道試產(chǎn)成功率，及不同方法對(duì)子宮下段肌層厚度的測(cè)量。結(jié)果：通過(guò)對(duì)各組患者子宮下段肌層厚度的檢測(cè)發(fā)現(xiàn)，四組患者的子宮下段肌層厚度間的差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。通過(guò)對(duì)各組患者采用陰道試產(chǎn)成功例數(shù)發(fā)現(xiàn)，四組患者在陰道試產(chǎn)成功率的比較上各組差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。通過(guò)對(duì)各組采用陰道試產(chǎn)失敗的患者再采用剖宮產(chǎn)手術(shù)，發(fā)現(xiàn)在術(shù)中及術(shù)后出血量和縮宮素用量的比較上各組差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），在子宮切口愈合不佳和新生兒窒息例數(shù)上各組差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：剖宮產(chǎn)術(shù)后再次妊娠時(shí)限在3年左右的患者子宮下段肌層厚度最佳，適合再次分娩，但是時(shí)間越長(zhǎng)子宮下段肌層厚度越薄，就會(huì)降低陰道試產(chǎn)的成功率。

【關(guān)鍵詞】剖宮產(chǎn)術(shù)后再次妊娠；時(shí)限；子宮下段肌層厚度

Relationship between interval of pregnancy after cesarean section and lower uterine segment thicknessWEN Ling1， HOU Shunyu2. 1. Department of Obstetrics and Gynecology， Zhangjiagang Traditional Chinese Medicine Hospital， Suzhou 215600， Jiangsu， China； 2. Department of Obstetrics and Gynecology， Suzhou Municipal Hospital， Suzhou 215002， Jiangsu， China

【Abstract】Objectives： To explore the relationship between interval of pregnancy after cesarean section and lower uterine segment thickness. Methods： 80 pregnant women after cesarean section in our hospital from January 2012 to January 2014 were enrolled， and by the interval from caesarean section to subsequent pregnancy were divided into group A （n=19， interval between ≤3 years）， group B （n=26， interval between 3 ～ 6 years）， group C （n=20， interval between 6 to 9 years） and group D （n=15， interval duration> 9 years）. The lower uterine segment thickness and the success rate of vaginal trial delivery and different measurement methods of lower uterine segment thickness were compared. Results： Differences in lower uterine segment thickness and the success rate of vaginal trial delivery among the four groups were statistically significant （P <0.05）. Patients failed vaginal trial delivery received cesarean section again， and statistically significant difference was found in the intraoperative and postoperative bleeding and oxytocin amount among the four groups （P <0.05）， while no significant difference in number of poor wound healing and cases of neonatal asphyxia （P> 0.05）. Conclusion： Women get pregnant 3 years after cesarean section have the most suitable lower uterine segment thickness， but the longer the interval is， the thinner lower uterine segment thickness becomes， which will reduce the success rate of vaginal trial delivery.

【Key words】Pregnancy after cesarean section； Interval； Lower uterine segment thickness

【中圖分類號(hào)】R714.2【文獻(xiàn)標(biāo)志碼】A

剖宮產(chǎn)術(shù)是產(chǎn)科領(lǐng)域中的重要手術(shù)，目前已成為解決難產(chǎn)和某些產(chǎn)科合并癥，挽救產(chǎn)婦和圍產(chǎn)兒生命的有效手段[1]，但是由于剖宮產(chǎn)后對(duì)再次妊娠時(shí)子宮下段肌層厚度的影響，可能會(huì)使患者出現(xiàn)子宮破裂、產(chǎn)后大出血等風(fēng)險(xiǎn)[2]，對(duì)母嬰的健康造成影響。在前次剖宮產(chǎn)術(shù)后形成瘢痕子宮的孕婦，再次進(jìn)行陰道試產(chǎn)時(shí)出現(xiàn)子宮破裂的危險(xiǎn)程度與子宮下段肌層厚度有密切關(guān)系[3]。本研究中通過(guò)對(duì)80例剖宮產(chǎn)術(shù)后再次妊娠不同時(shí)限患者的子宮下段肌層厚度的探討，分析研究患者在不同時(shí)限的分娩的危險(xiǎn)程度，從而選擇合適的時(shí)限進(jìn)行分娩。en……