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1、剖宫产术子宫下段横切口撕裂伤相关因素分析与对策陈翠英盐城市射阳县千秋镇卫生院(江苏盐城)224352[摘要]目的:分析剖宫产术子宫下段横切口相关因素,并采取积极有效的干预措施,为断提高剖宫产术医疗质量。方法:对我院2010年1月-2013年6月11例剖宫产术子宫下段横切口撕裂伤产妇的临床资料进行回顾性分析。结果:2010年1月-2013年6月,我院共实施剖宫产术378例,发生子宫下段横切口撕裂伤27例,占7.14%。其中主要影响因素为枕后位10例,占37.03%;麻醉效果不佳及超体重胎儿各4例,各占14.81%;瘢痕子宫2例,
2、占7.41%;子宫下段形成不良3例,占11.11%。结论:剖宫产术子宫下段横切口撕裂伤是剖宫产术常见并发症症,主要影响因素为胎位、太先露方式、麻醉效果、胎儿体重、瘢痕子宫、子宫下段形成不良等,手术技能也是不可回避的因素。因此,加强术前评价、术中细致操作,在子宫下段横切口的基层上采取“┻”或“U”切口,以增加切口的有效面积,减少撕裂伤发生率。[关键词]剖宫产术;切口撕裂伤;相关因素;分析与对策Transverseloweruterinesegmentcesareansectionincisionlacerationsrelate
3、dfactorsandcountermeasuresChencui-YingSheyangQianqiutownhospitalsinYancheng;(Yancheng)224,352,china[Abstract]Objective:Toanalyzetheloweruterinesegmentcesareansectiontransverseincision-relatedfactors,andtakepositiveandeffectiveinterventions,inordertocontinuouslyimpro
4、vethequalityofmedicalcarecesareansection.Methods:ThehospitalinJanuary2010-2013onJune11casesofcesareanuterinesegmenttransverseincisionlacerationsmaternalclinicaldatawereretrospectivelyanalyzed.Results:January2010,June2013,ourhospitalimplementedatotalof378casesofcesar
5、eansection,uterinesegmenttransverseincisionlaceration27cases,accountingfor7.14percent.Wherethemainfactorsforthepillow-bit10cases,accountingfor37.03%;pooranestheticeffectandultra-fourcasesoffetalweight,eachwith14.81percent;uterinescartwocases,accountingfor7.41%;adver
6、sethreecasesformedtheloweruterinesegment,accountingfor11.11%.Conclusion:Theloweruterinesegmentcesareansectiontransverseincisionlacerationsyndromeisacommoncomplicationofcesareansection,themainfactorsforthefetalposition,firstexposedwaytoomuch,anesthesia,fetalweight,ut
7、erinescar,theloweruterinesegmentandpoorform,surgeryskillsarealsoanunavoidablefactor.Therefore,strengtheningthepreoperativeevaluation,surgeryandmeticulousoperation,totake"┻"or"U"incisionintheloweruterinesegmenttransverseincisioninthegrassrootslevel,inordertoincreaset
8、heeffectiveareaoftheincision,toreducetheincidenceoflacerations.[Keyword]cesareansection;incisionlaceration;relatedfactors;AnalysisandCount