مقایسه عوارض زودرس مادری سزارین در دو روش بستن و بازگذاشتن پریتوئن جداری: یک مطالعه کارآزمایی بالینی دوسوکور

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد اتاق عمل، کمیته تحقیقات دانشجویی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران.

2 استادیار گروه اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران.

3 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران.

چکیده

مقدمه: سزارین با دو روش ترمیم و عدم ترمیم پریتوئن انجام می­شود، اما در مورد مزایا و معایب این دو روش اختلاف نظر وجود دارد. بر همین اساس مطالعه حاضر با­ هدف مقایسه عوارض زودرس مادری سزارین در دو روش بستن و بازگذاشتن پریتوئن جداری انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی دو­سوکور در سال 1398 بر­ روی 120 بیمار کاندید سزارین در بیمارستان فاطمیه همدان انجام گرفت. نمونه­ها به‌صورت تصادفی در دو گروه 60 نفری ترمیم (گروه شاهد) و عدم ترمیم پریتوئن (گروه مداخله) قرار گرفتند. حین و بعد از جراحی عوارض زودرس مادری ثبت شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) و آزمون­های کای اسکوئر، تی مستقل و اندازه‌گیری مکرر انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته­ها: نتایج نشان داد مدت زمان جراحی و خونریزی حین جراحی در بیماران با روش عدم ترمیم به‌طور معنادار کمتر بود (05/0>p). همچنین مدت زمان ایلئوس، مقدار مسکن دریافتی و درد 12 و 24 ساعت بعد از جراحی در بیماران با روش عدم ترمیم به‌طور معنادار کمتر بود (05/0>p)، اما دو گروه از نظر بروز درد 6 ساعت بعد جراحی و علائم بروز عفونت زخم جراحی تفاوت معنا­داری نداشتند (05/0<p).
نتیجه‌گیری: در سزارین با روش عدم ترمیم پریتوئن عوارضی همچون خونریزی حین جراحی، مدت زمان جراحی، ایلئوس بعد جراحی، درد و مصرف مسکن با شدت کمتری نسبت به سزارین با روش ترمیم پریتوئن بروز خواهد کرد، اما این دو روش از نظر بروز عفونت زخم جراحی تفاوتی ندارند.

کلیدواژه‌ها

عنوان مقاله [English]

Early maternal complications of cesarean section in two technique of Closure and non-closure of parietal peritoneum: a double blind randomized clinical trial

نویسندگان [English]

  • Mehrnush Mostafaei 1
  • Behzad Imani 2
  • Shirdel Zandi 1
  • Soghra Rabiei 3
1 M.Sc. Student of Operating Room, Student Research Committee, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran.
2 Assistant professor, Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran.
3 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
چکیده [English]

Introduction: Cesarean section is performed with two technique of closure or non-closure of the peritoneum, but there is disagreement about the advantages and disadvantages of these techniques. Accordingly, this study was performed with aim to compare the early maternal complications of cesarean section in two technique of closure or non-closure of the parietal peritoneum.
Methods: This double-blind randomized clinical trial study was performed on 120 patients undergoing cesarean section at Hamadan Fatimah Hospital in 2019. Samples were randomly divided into two groups: closure of the peritoneum (n=60) and non-closure of the peritoneum (n=60). The maternal complications during and after surgery were recorded. Data were analyzed by SPSS software (version 21) and Chi-square, independent t-test and repeated measures.
Results: The results showed that operative time and bleeding during surgery were significantly fewer in patients receiving non-closure technique (p<0.05). Also, the duration of ileus, the amount of received analgesic, and pain 12 and 24 hours after the surgery were significantly lower in patients receiving non-closure technique (p <0.05). However, there was no significant difference between the two groups in terms of pain after 6 hours of the surgery and the symptoms of surgical wound infection (p> 0.05).
Conclusion: The complications such as bleeding during surgery, the duration of surgery, ileus after surgery, pain, and consumption of analgesic will occurs with less intensity in patients receiving non-closure technique than patients with closure technique; however, these two methods were not different in terms of surgical wound infection.

کلیدواژه‌ها [English]

  • Cesarean section
  • Maternal early complications
  • Parietal peritoneum

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 24، شماره 1
فروردین 1400
صفحه 77-86

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