严重产伤性耻骨联合分离致会阴裂伤一例

耻骨联合分离是产后少见的并发症,严重产伤性耻骨联合分离更为少见。回顾分析1例经阴道分娩后发生耻骨联合分离致会阴裂伤的病例,患者会阴部严重裂伤及撕脱伤,深达右侧穹窿,上达耻骨联合及前盆壁,耻骨联合下方空虚,耻骨联合分离78.37 mm,患者不能改变体位,考虑严重产伤性耻骨联合分离致会阴裂伤,行全身麻醉下耻骨联合复位内固定术+阴道检查+会阴裂伤修补术+膀胱镜检查术,患者产后6周可搀扶下床活动。严重产伤性耻骨联合分离行复位内固定手术可快速回复骨盆解剖结构,促进康复。

A Case of Perineal Laceration Caused by Severe Obstetric Traumatic Pubic Symphysis Separation

Pubic symphysis separation is a rare complication after delivery, and severe obstetric traumatic pubic symphysis separation is even more rare. A case of perineal laceration caused by separation of pubic symphysis after vaginal delivery was retrospectively analyzed. The patient had severe laceration and avulsion of perineum, which reached to the right fornix, up to the pubic symphysis and anterior pelvic wall, the lower part of pubic symphysis was empty, and the separation of pubic symphysis was 78.37 mm. The patient could not change her body position. Considering the perineal laceration caused by severe obstetric traumatic pubic symphysis separation, the patients should be treated with reduction and internal fixation of pubic symphysis + vaginal examination + perineal laceration repair + cystoscopy under general anesthesia. The patients can be helped out of bed at 6 weeks postpartum. For severe obstetric traumatic pubic symphysis separation, reduction and internal fixation can quickly restore the anatomical of pelvis structure and promote rehabilitation.