横切口顶入式腹膜外剖宫产与传统剖宫产术式比较研究

摘要

目的 探讨横切口顶入式腹膜外剖宫产在产程半进展胎头低入孕妇中的应用.方法 有剖宫产手术指征的产程半进展胎头低入孕妇600例,行横切口顶入式腹膜外剖宫产术469例为观察组,行横切口高位子宫下段剖宫产术131例为对照组,比较两组患者手术时间、胎儿分娩时间、术中出血量、术后血常规、切口愈合程度、术后恢复(肛门排气、进食时间)及术后并发症(腹腔内子宫内膜异位症及宫外孕发生)情况,术后膀胱功能影响情况.结果 观察组产妇手术时间、胎儿分娩时间、术中出血量、术后血常规、切口愈合程度、术后恢复(肛门排气、进食时间)及术后并发症与对照组比较,差异有统计学意义(P<0.05).两组术后膀胱功能影响,差异无统计学意义(P>0.05).结论 横切口顶入式腹膜外剖宫产具有手术时间短、术时术后出血量少、切口愈合好,术后恢复快、肛门排气早,能早期进食,术后腹腔内子宫内膜异位症及宫外孕发生几率及手术损伤小等优点,术后膀胱功能无明显影响,值得在临床上推广应用,尤其适用于再次剖宫产(前次手术有腹腔粘连患者).%Objective To study on the pubic crosscutting mouth into the type of extraperitoneal cesarean delivery half compared with the traditional cesarean operation in the stages of progress in the application of the fetal head low in pregnant women.Methods 690 cases with cesarean section surgery indications of half progress fetal head low labor in pregnant women were chosen,388 of whom underwent suprapubic cystotomy crosscutting mouth into the type of extraperitoneal cesarean section as a team,302 regular crosscutting mouth high lower uterine segment cesarean section surgery as the control group,two groups of patients with surgical time,fetal childbirth time,intraoperative blood loss,postoperative routine blood,healing of incision,postoperative recovery,anal exhaust,eating time and postoperative complications(abdominal cavity endometriosis and ectopic pregnancy),postoperative bladder function influence were compared.Results Two groups of patients with surgical time,fetal childbirth time,intraoperative blood loss,postoperative routine blood,healing of incision,postoperative recovery,anal exhaust,eating time and postoperative complications(abdominal cavity endometriosis and ectopic pregnancy)were compared and the results had significant difference(P<0.05). Two groups of postoperative bladder function influence,there was no statistically significant difference(P>0.05).ConclusionOn the pubic crosscutting mouth into the type of extraperitoneal cesarean section has the advantages of has a shorter operative time, less bleeding, postoperative incision healing, rapid postoperative recovery, anus exhaust early, early feeding, postoperative peritoneal endometriosis and ectopic pregnancy incidence and small surgical damage etc. There is no obvious effect on bladder function after operation, and it is worth popularizing in clinic,especially for the re cesarean section (the patients who have the abdominal cavity adhesion before operation).