哺乳期疤痕子宫人工流产手术方法及风险分析

夏玫 张海荣

【[摘要] 目的 探討哺乳期疤痕子宫人工流产手术方法及风险。方法 方便选取86例于2016年2月—2017年1月在日照市东港区妇幼保健站妇产科行人工流产的哺乳期疤痕子宫患者为研究对象，将其随机分为对照组和观察组，对照组采取单用负压吸引人工流产法实施人工流产术，观察组利用米索前列醇及利多卡因进行局麻后行人工流产术，观察并比较两组患者宫颈松驰情况及手术效果。结果 观察组宫颈松驰总有效率明显高于对照组（93.02% vs 74.42%），组间比较差异有统计学意义（P<0.05）；观察组术中出血量及疼痛程度均明显低于对照组，组间比较差异有统计学意义（P<0.05）；观察组流产完全率为93.02%，明显高于对照组的72.09%，组间比较差异有统计学意义（P<0.05）。结论 针对哺乳期疤痕子宫患者，利用米索前列醇及利多卡因进行局麻后行人工流产术有利宫颈松驰，降低手术风险，减少术中出血量，减轻患者疼痛，同时提高流产完全率，具良好手术效果，值得在临床当中推广应用。

[关键词] 哺乳期；疤痕子宫；人工流产手术

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）02（a）-0013-03

Surgical Methods and Risk Analysis of Artificial Abortion in Uterus during Lactation

XIA Mei1， ZHANG Hai-rong2

1.Donggang District Women and Children Health Care Station， Rizhao， Shandong Province， 276800 China； 2.Obstetrics and Gynecology Department，the Second Peoples Hospital of Rizhao， Rizhao， Shandong Province， 276800 China

[Abstract] Objective This paper tries to explore the surgical methods and risks of artificial abortion in the uterus of lactation. Methods Eighty-six patients with uterus of breast-feeding of uterus during lactation period were convenient selected from February 2016 to January 2017 of induced abortion of obstetrics and gynecology department. The patients were randomly divided into control group， observation group. The control group took a single negative pressure to attract artificial abortion law to implement abortion， the observation group using misoprostol and lidocaine for abortion after abortion， observation and comparison of the two groups of patients with cervical relaxation and surgical results. Results The total effective rate of cervical relaxation was significantly higher than that of the control group （93.02% vs 74.42%）， and there was significant difference between the two groups（P<0.05）. The bleeding volume and pain in the observation group were significantly lower than those in the control group（P<0.05）. The complete rate of miscarriage was 93.02% in the observation group， which was significantly higher than that in the control group（72.09%）. There was significant difference between the two groups（P<0.05）. Conclusion For patients with lactating scar wounds， the use of misoprostol and lidocaine for local anesthesia after artificial abortion is conducive to cervical relaxation， which can reduce the risk of surgery to reduce intraoperative blood loss， reduce patient pain， while improving the abortion rate， with good surgical results， so it is worth to promote and applied in clinical practice.

[Key words] Lactation； Scarred uterus； Artificial abortion surgery

近些年来，伴随医疗水平及人们生活水平的提高，要求行剖宫产进行分娩的人越来越多，这就使得疤痕子宫的发生率越来越高，哺乳期疤痕子宫再次妊娠的发生率也明显提升[1]。哺乳期疤痕子宫再妊娠属危险妊娠类型，行人工流产术的风险也非常大，为此，临床不断深入研究，以寻找一种安全、有效的手术方法[2]。该案方便选取86例该院于2016年2月—2017年1月行人工流产术的哺乳期疤痕子宫患者为研究对象，采取利用米索前列醇及利多卡因进行局麻后再行人工流产术的方法实施手术，并取得了良好手术效果，现报道如下。

1 资料与方法

1.1 一般资料

方便选取86例于在该院行人工流产的哺乳期疤痕子宫患者为研究对象，让所有患者均经超声确诊宫内妊娠，无人工流产禁忌证，知晓该案研究内容并签署知情同意书。……