剖宫产时关腹与不关腹对粘连的影响：一项前瞻性随机研究。
Effect of closure versus nonclosure of peritoneum at cesarean section on adhesions: a prospective randomized study.
机构信息
Department of Obstetrics and Gynecology, Barzilai Medical Center Faculty of Health Sciences, Ben Gurion University of the Negev, Ashkelon, Israel.
出版信息
Am J Obstet Gynecol. 2012 Jan;206(1):56.e1-4. doi: 10.1016/j.ajog.2011.07.032. Epub 2011 Jul 29.
OBJECTIVE
We sought to determine the effect of nonclosure of the visceral and parietal peritoneum during cesarean section on the formation of adhesions.
STUDY DESIGN
This was a prospective randomized trial of 533 women undergoing primary cesarean section; in 256 the peritoneum was left open and in 277 it was closed. Fifty women in the nonclosure group and 47 women in the closure group were subsequently evaluated intraoperatively at a repeat cesarean. The presence of adhesions and their severity were evaluated at several sites.
RESULTS
The nonclosure and closure groups were comparable with regard to the proportion of patients with adhesions at any site (60% vs 51%, respectively; P = .31). Time from incision to delivery was comparable in the nonclosure and closure groups (8.98 ± 4.7 vs 9.32 ± 5.2 minutes, respectively; P = .84).
CONCLUSION
Closure or nonclosure of the peritoneum at cesarean section did not lead to large differences in the adhesion rate.
目的
我们旨在确定剖宫产术中不关闭腹膜对粘连形成的影响。
研究设计
这是一项对 533 名行初次剖宫产术的妇女进行的前瞻性随机试验；其中 256 例腹膜未关闭，277 例腹膜关闭。在非关闭组的 50 名妇女和关闭组的 47 名妇女随后在再次剖宫产时进行了术中评估。在几个部位评估粘连的存在及其严重程度。
结果
粘连在任何部位的患者比例在非关闭组和关闭组之间无显著差异（分别为 60%和 51%；P=.31）。非关闭组和关闭组的切口至分娩时间无显著差异（分别为 8.98±4.7 分钟和 9.32±5.2 分钟；P=.84）。
结论
剖宫产时关闭或不关闭腹膜并不会导致粘连发生率的显著差异。
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