改良式新式剖宫产术60例分析

目的 探讨改良式新式剖宫产与传统的子宫下段剖宫产在术式、手术指征、手术时间、胎儿娩出时间、切口撕裂、术中出血及术后恢复等方面的差异。方法 采用了以色列Toel-Cohen开腹方式,钝性撕开脂肪及腹直肌,纵形撕开壁层腹膜,钝性撕开膀胱反折腹膜,子宫下段切口上下方向钝性撕开,术中缝合应用美国氰胺公司生产的DG缝合线,用一根线依次全层缝合子宫下段,不缝合子宫反折腹膜和壁层腹膜。另一根线连续缝合浅筋膜及2/3层皮下脂肪,不打结折回皮内缝合皮肤,留线头5 cm。术后不拆线。结果 本术式术后排气时间由原来的48±5 h缩短至6±5 h,(P<0.01)术后疼痛时间由原来的24±1 h缩短至2±1 h,切口均Ⅰ期愈合。结论 此术优于传统的子宫下段剖宫产,明显缩短了手术时间,胎儿娩出时间,无切口撕裂,减少了产后出血,术后疼痛轻,下床活动早,排气快,术后切口不拆线,无硬结,术后病率少,疤痕纤细,切口美观,易于掌握,值得推广。

A modified caesarean section analysis of 60 cases.

Objective To explore the differences between the modified caesarean section and traditional lower segment caesarean section in clinical aespects. Methods During the operation a blunt dissection was made in the bladder peritoneum and the lower segment after the Toal - Cohen's laparotomy. The incision of uterus was continuously sutured with the DG suture . The bladder peritoneuim and abdominal peritoneum were not sutured. The superficial fascia and 2/3 subcutaneous fat were sutured with another line. The stitches of abdominal incision wasn't removed. Results The differences in the amount of bleeding, and the time of postoperative exsuffla-tion and postoperative pain were significant (p<0. 01) between the modified group and traditional group. Conclusion The modified caesarean section is more effective in shortening the time of operation and postoperative pain and in reduction of postpartum bleeding than that of traditional caesarean section.