Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
Int J Gynaecol Obstet. 2010 Nov;111(2):175-8. doi: 10.1016/j.ijgo.2010.06.009. Epub 2010 Aug 14.
To compare the rates of intraoperative and postoperative complications of uterine repair when performed in situ or extra-abdominally following cesarean delivery.
In this prospective randomized study 4925 women who underwent cesarean delivery were randomly assigned to in situ (n = 2462) or extra-abdominal (n = 2463) uterine repair (group 1 and group 2, respectively). The study compares drop in hemoglobin concentration (as a measure of intraoperative blood loss). It also compares operating time, time to return of bowel sound, and duration of hospitalization as well as rates of uterine atony, blood transfusion, intraoperative complications, additional use postoperative analgesics, endometritis, and wound infection.
Uterine atony developed in 96 women (3.8%) in group 1 and 226 women (9.1%) in group 2 (P = 0.001). Moreover, the operating time and the time to return of bowel sound were shorter and the rates of both additional use of postoperative analgesics and wound infection were lower in group 1 (P = 0.001, P = 0.002, P = 0.001, and P = 0.003, respectively).
Fewer cases of uterine atony, a shorter operating time, a faster return of bowel function, a lesser need for postoperative analgesics, and lower rates of additional use of postoperative analgesics and wound infections suggest that in-situ uterine repair ought to be preferred to extra-abdominal uterine repair following cesarean delivery.
比较剖宫产术后原位与腹部外修补子宫时术中及术后并发症的发生率。
在这项前瞻性随机研究中，4925 名接受剖宫产术的妇女被随机分配至原位（n = 2462）或腹部外（n = 2463）子宫修复（分别为组 1 和组 2）。本研究比较了血红蛋白浓度下降（作为术中失血量的衡量标准）。它还比较了手术时间、肠鸣音恢复时间和住院时间，以及子宫收缩乏力、输血、术中并发症、术后额外使用止痛药、子宫内膜炎和伤口感染的发生率。
组 1 中有 96 名妇女（3.8%）发生子宫收缩乏力，组 2 中有 226 名妇女（9.1%）发生子宫收缩乏力（P = 0.001）。此外，组 1 的手术时间和肠鸣音恢复时间更短，术后额外使用止痛药和伤口感染的发生率也更低（P = 0.001，P = 0.002，P = 0.001 和 P = 0.003）。
子宫收缩乏力的发生率较低，手术时间较短，肠蠕动恢复较快，术后止痛药的需求较少，术后额外使用止痛药和伤口感染的发生率较低，提示剖宫产术后原位子宫修复应优于腹部外子宫修复。
