足月剖宫产术后子宫切口瘢痕憩室 发生情况及影响因素分析

Analysis of the Occurrence and Influencing Factors of Uterine Incision Scar Diverticulum after Full-term and Cesarean Section

摘要:

〔摘 要〕 目的：探究足月剖宫产术后子宫切口瘢痕憩室发生情况及影响因素，以为足月剖宫产术后子宫切口瘢痕憩室 防控措施的制定提供参考依据。 方法：选取建瓯市总医院 2020 年 1 月至 2022 年 10 月期间收治的 128 例足月剖宫产产妇为 研究对象，将其子宫切口瘢痕憩室发生率进行统计，并比较不同年龄、产次、孕次、妊娠期合并症情况、合并基础疾病情况、 胎膜早破情况、产后感染情况、切口位置、手术时间、子宫位置、术中出血量、贫血情况、手术时机、血清白蛋白水平及 体质量增加情况者的子宫切口瘢痕憩室发生率，采用多因素 logistic 回归分析足月剖宫产术后子宫切口瘢痕憩室发生的影响 因素。 结果：本研究 128 例足月剖宫产产妇中，22 例发生子宫切口瘢痕憩室，发生率为 17.19 %，不同年龄、产次、孕次、 手术时间、术中出血量、贫血情况、手术时机及血清白蛋白水平产妇的子宫切口瘢痕憩室发生率比较，差异无统计学意义 （P ＞ 0.05）；不同妊娠期合并症情况、合并基础疾病情况、胎膜早破情况、产后感染情况、切口位置、子宫位置及体质 量增加情况者的子宫切口瘢痕憩室发生率比较，差异具有统计学意义（P ＜ 0.05）；多因素 logistic 回归分析显示，有妊娠 期合并症、合并基础疾病、有胎膜早破、有产后感染、切口位置近宫颈内口、子宫后位及体质量增加≥ 20 kg 是足月剖宫产 产妇术后子宫切口瘢痕憩室发生的危险因素（P ＜ 0.05）。 结论：足月剖宫产术后子宫切口瘢痕憩室发生率较高，且其影 响因素较多，本研究多因素 logistic 回归分析结果可作为子宫切口瘢痕憩室防控措施制定的参考依据。

Abstract:

〔Abstract〕 Objective To investigate the occurrence of uterine incision scar diverticulum and influencing factors of patients with full-term and cesarean section, in order to provide evidence for the development of prevention and control measures for uterine incision scar diverticulum after full-term and cesarean section. Methods A total of 128 cases of full-term and cesarean section in General Hospital of Jian'ou City from January 2020 to October 2022 were selected as the study objects, and the uterine incision scar diverticulum rate of delivery women was analyzed, and the uterine incision scar diverticulum rates of delivery women with different ages, number of birth, number of pregnancy, pregnancy complications, basic diseases, premature rupture of membranes, postpartum infection, incision position, operation time, uterine position, intraoperative bleeding, anemia, operation time, serum albumin level and weight gain situation were compared, then the influencing factors of uterine incision scar diverticulum occurrence of patients with full-term and cesarean section were analyzed with multi-factor logistic regression analysis. Results 22 cases of 128 patients with full-term and cesarean section were with uterine incision scar diverticulum, the rate was 17.19%, and the uterine incision scar diverticulum rates of delivery women with different ages, number of birth, number of pregnancy, operation time, intraoperative bleeding, anemia, operation time and serum albumin level were compared, the differences were not statistically significant (P > 0.05), the uterine incision scar diverticulum rates of delivery women with different pregnancy complications, basic diseases, premature rupture of membranes, postpartum infection, incision position, uterine position and weight gain situation were compared, the differences were statistically significant (P < 0.05), the multi-factor logistic regression analysis showed the pregnancy complications, basic diseases, premature rupture of membranes, postpartum infection, incision position, uterine position and weight gain situation were the influencing factors of uterine incision scar diverticulum occurrence of patients with full-term and cesarean section (P < 0.05). Conclusion The uterine incision scar diverticulum rate of patients with full-term and cesarean section is higher, and its influencing factors are more. The results of multi-factor logistic regression analysis can be as the reference for the formulation of prevention and control measures for uterine incision scar diverticulum.