2403 Cases Of Pelvic Adhesions Conditions In Gynecologic Surgery And Related Factors Analysis

Objective:To avoid the risk caused by pelvic adhesions to gynecological surgery and find measures to prevent pelvic adhesions, the clinical data of patients with pelvic adhesions was retrospectively reviewed to discuss the impact of pelvic adhesion to perioperative period of gynaecology and conform the susceptible factors of female pelvic adhesions. Methods:2403 patients were selected among all sorts of gynecological disease by abdominal surgery in the first hospital of Ji Lin university from January 2014 to December 2014. We use the retrospective comparative and Logistic regression methods to analyze the clinical data. Results:(1) Pelvic adhesion rate of total patients was 43.7%.Pelvic adhesions are mainly occurred in women aged 21 to 50 that is sexually active and child-bearing age,and it accounts for 82.2% all of patients with pelvic adhesions.The rate of pelvic adhesion was 15.4% during aged less than 20 patients who are unmarried and childless. Pelvic adhesion rate of patients with gynecological surgery in town was 47.0%, higher than 40.2% of rural patients.(2) The pelvic adhesion rate of patients without hypogastrium operation history was 35.1%, lower than 57.9% of the patients who have hypogastrium operation history. The pelvic adhesion rate of patients was respectively 100%、83.3%、78.8%、73.4%,whose reason of previous surgery was respectively pelvic inflammatory disease、endometriosis、uterine fibroids and oothecoma,among 906 patients with hypogastrium operation history.Results of Logistic regression analysis: hypogastrium operation history is independent risk factors for pelvic adhesions.With the increase of operations, the rate of pelvic adhesion are increasing.(3) 39.3% of the patients has one or more cesarean section among 906 patients who have hypogastrium operation history.And pelvic adhesion rate of patients was 61.2%, who have the history of cesarean section.(4) 61.0% of the patients has pelvic adhesions among patients who have pelvic inflammatory disease history.And 9.6% of the patients has pelvic inflammatory disease history among patients without pelvic adhesions.There is statistical significance between them, χ2=715.723,P=0.000.(5) 281(26.8%) patients have endometriosis among 1050 patients with pelvic adhesions, but only 61 patients have endometriosis among patients without pelvic adhesions. There is statistical significance between them, χ2=239.844, P=0.000. 82.2% of endometriosis patients has pelvic adhesions.(6) Pelvic adhesions make surgery hard. 5.1% of the patients with pelvic adhesions need surgical consultation in the process of operation, it is significantly higher than 0.38% of the patients with pelvic without adhesion, P=0.0001; the average operation time of patients with pelvic adhesions is 131.25 minutes, it is significantly longer than the 119.75 minutes of patients without pelvic adhesions, P=0.01. Conclusion:(1) Compared with other age groups of patients,the pelvic adhesion rate of growth period women is high in the pelvic and abdominal surgery.(2) The history of pelvic surgery is an important factor of pelvic adhesions. The surgery of pelvic inflammatory disease, endometriosis and uterine fibroids is more likely to cause pelvic adhesions. And pelvic adhesions were positively correlated with the number of operation.(3) The high rate of cesarean delivery and the number of cesarean section are closely associated with pelvic adhesions.(4) Pelvic adhesions increased gynecological surgery difficulty and risk.