再生育政策下腹膜内与腹膜外剖宫产再妊娠 结局的比较研究进展

Research Progress on the Comparison of Re-Pregnancy Outcomes between Intraperitoneal and Extraperitoneal Cesarean Section under the Updated Birth Policy

摘要: 腹膜内剖宫产(intraperitoneal cesarean section, TCS)与腹膜外剖宫产(extraperitoneal cesarean section, ECS)是两种主要的剖宫产术式。随着生育政策的调整和再次剖宫产率的上升，不同剖宫产的近期及远期结局需重新审视。现有研究多关注腹膜内剖宫产(TCS)与腹膜外剖宫产(ECS)的短期结局，但缺乏基于“再生育需求”背景下的远期结局比较。本研究系统比较两种术式的近期结局(胃肠功能恢复、住院时间等)与远期价值(腹腔粘连程度、再次剖宫产难度、手术损伤风险及产妇远期心理影响)，旨在重新审视两种术式在近期及远期结局的优劣，从而为产妇个性化选择剖宫产方式提供更可靠的参考依据。

Abstract: Intraperitoneal cesarean section (TCS) and extraperitoneal cesarean section (ECS) are two primary surgical approaches for cesarean delivery. With the adjustment of fertility policies and the increasing rate of repeat pregnancies, the short- and long-term outcomes of different cesarean techniques need to be reassessed. Existing studies have mostly focused on the short-term outcomes of TCS versus ECS, but there is a lack of long-term outcome comparisons in the context of women with future fertility needs. This study systematically compares the short-term outcomes (gastrointestinal function recovery, length of hospital stay, surgical complications) and long-term value (degree of intra-abdominal adhesions, difficulty of repeat cesarean section, risk of surgical injury, and long-term psychological impact on the mother) between the two techniques, aiming to reevaluate their relative advantages and disadvantages in both short- and long-term outcomes, and to provide evidence-based guidance for individualized surgical decision-making.