下腹横切口半腹膜外剖宫产92例临床分析  

Ventral Crosscutting Mouth Half Extraperitoneal Cesarean Section of 92 Cases of Clinical Analysis

作　　者：杨晓华 

机构地区：[1]四川省成都市龙泉驿区第二人民医院妇产科,610108

出　　处：《医学理论与实践》2013年第24期3237-3238,3241,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨下腹横切口半腹膜外剖宫产术式的可行性、安全性、适应证、主要操作技巧及临床应用价值。方法:将200例有剖宫产手术指征并排除有特殊病情的孕妇,告知手术方式取得知情同意后随机分为两组:半腹膜外组(观察组)92例采用半腹膜外剖宫产术式,腹膜内组(对照组)108例采用下腹横切口子宫下段剖宫产术式。两组的年龄、孕周、手术指征差异无统计学意义(P>0.05),具有可比性。两组均选择持续硬膜外麻醉。两组手术均由同一术者实施,术前准备及术后护理相同。结果:两组开腹时间、术中出血量无差异。切皮至胎儿娩出时间观察组比对照组略有延长,但总手术时间无明显差异。术后病率观察组比对照组低,排气时间观察组比对照组缩短,两组差异有显著性(P<0.05)。观察组住院时间平均5.84d,对照组住院时间平均7.51d,两组差异有显著性(P<0.05)。两组均无膀胱、肠管等脏器损伤。新生儿出生1min Apgar评分两组无差异。结论:半腹膜外剖宫产术具有腹膜外剖宫产的不干扰腹腔脏器、术后痛苦小、恢复快、病率低和子宫下段剖宫产的手术时间短,手术方法简单、胎儿娩出迅速、膀胱损伤风险小、能探查附件的优点,且符合微创手术的原则。手术安全可行,值得推广。Objective： To explore the feasibility of the ventral crosscutting mouth half extraperitoneal cesarean opera- tion safety indications main skills and clinical value. Methods： 200 patients with cesarean section surgery indications and exclusion of pregnant women with special condition, told operation after obtaining informed consent were randomly di- vided into two groups：half of extraper[toneal group （observation group） 92 cases using half of extraperltoneal cesarean operation, peritoneal group （control group） within 108 cases with lower abdomen crosscutting mouth lower uterine segment cesarean delivery operation. The gestational age of surgical indications similar between the two groups has no statistical significance （P〉0. 05）, comparable in the two groups all choose continuous epidural anesthesia in the two groups are performed by the same performer preoperative preparation and postoperative nursing are the same. Results： The bleeding amount of open time difference between the two groups cut skin to fetal childbirth time observation group than the control group a slightly longer, but no difference between the total operation time. Postoperative disease rate of observation group is lower than control group, the observation group than the control group to shorten the exhaust time, were significant differences between the two groups （P＇~0. 05）. Observation group hospitalization time average 5. 84 days controls the length of time an average of 7. 51 days. Were significant differences between the two groups （P d0. 05） in the two groups had no bladder, bowel and viscera damage. The birth of I rain Apgar score two groups have no difference. Conclusion： Extraperitonea] cesarean section with extraperitoneal cesarean section does not interfere with the abdominal viscera postoperative pain little lower rate faster recovery and lower uterine segment cesarean section in the shorter operation time, surgical method is simple and fetal childbirth can quickly at low risk of bladder injury to pr

关 键 词：剖宫产术半 腹膜外 下腹横切口 

分 类 号：R719.8[医药卫生—妇产科学]