术者手体积与剖宫产术中子宫切口撕裂的相关性  

Correlation between physician hand volume and uterine laceration in cesarean section

作　　者：刘丽 

机构地区：[1]河南省郸城县第二人民医院妇产科,郸城477150

出　　处：《临床医学》2015年第7期34-35,共2页Clinical Medicine

摘　　要：目的探讨医师手体积与剖宫产术中子宫切口撕裂的相关性。方法选择2006年3月至2012年5月行剖宫产术的产妇5386例,2011年6月以后胎头娩出困难者采用大S拉钩辅助胎头娩出。分四组统计,徒手胎头娩出术者手体积<300 ml为A组,>300 ml为B组,S拉钩辅助胎头娩出后术者手体积<300 ml为C组,>300 ml为D组。记录手术医师姓名及手体积、胎儿体质量、胎先露、胎头嵌入产道程度、子宫切口是否撕裂及撕裂程度、术后产妇疼痛程度。结果 5386例剖宫产手术中子宫切口撕裂538例,其中A组127例、B组246例、C组81例、D组84例,子宫切口撕裂与手术医师手体积、胎儿体质量、胎先露、胎头嵌入产道程度呈正相关(P<0.05)。结论术者手体积对子宫切口撕裂有直接诱发作用,采用大S拉钩辅助胎头娩出能有效避免子宫切口撕裂,降低并发症发生率。Objective To investigate the correlation between physician hand volume and uterine laceration in cesarean section. Methods From March 2006 to May 2012,5386 parturient underwent cesarean section were selected,fetal head was delivered by the large S retractor auxiliary after June 2011. They were divided into four groups of statistics,the delivered of fetal head by unarmed： surgeon＇s hand volume 〈300 ml was group A, 〉300 ml was group B; The delivered of fetal head by the S retractor auxiliary： surgeon＇s hand volume 〈300 ml was group C,and 〉300 ml was group D. The surgeon＇s name and hand volume,fetal weight,fetal presentation,the fetal head embedded in the birth canal extent,whether the uterine incision tear and tear extent,the degree of postoperative pain were recorded. Results Five hundred and thirty-eight of 5386 parturient underwent cesarean section had the uterine incision tear with 127 cases in group A,246 cases in group B,81 cases in group C,84 cases in group D,tearing the uterine incision was positively correlated with the surgeon＇s hand volume,fetal weight fetal presentation,fetal head embedded in the birth canal extent（ P〈0. 05）. Conclusion Volume of the surgeon＇s hand has directly induced effect with the uterine incision tear,the delivered of fetal head by using the large S retractor auxiliary can effectively avoid tearing the uterine incision and reduce complications.

关 键 词：剖宫产 子宫切口撕裂 胎头娩出困难 

分 类 号：R719.8[医药卫生—妇产科学]