新式剖宫产手术方式的探讨

STUDY ON THE NEW METHOD OF CESAREAN SECTION

目的：比较新式剖宫产术（ｔｈｅＭｉｓｇａｖＬａｄａｃｈｍｅｔｈｏｄ）与传统腹壁横切口子宫下段剖宫产术（Ｐｆａｎｎｅｎｓｔｉｅｌ）。方法：比较５４例新式剖宫产与４２例传统腹壁横切口子宫下段剖宫产。新方法包括：使用ＪｏｅｌＣｏｈｅｎ方法开腹，不缝合膀胱腹膜反折与腹膜，一层缝合子宫下段切口，腹壁切口仅缝合２～３针。结果：观察组胎儿娩出的平均时间为（５±３）ｍｉｎ，对照组为（１０±４）ｍｉｎ，Ｐ＜０．０１；观察组术中出血为（１３４±６２）ｍｌ，对照组为（１９３±１０５）ｍｌ，Ｐ＜０．０１；观察组术后肠蠕动恢复时间为（２０±９）ｈ，对照组为（３４±９）ｈ，Ｐ＜０．０１，观察组术后疼痛时间为（９±１１）ｈ，对照组为（２４±１２）ｈ，Ｐ＜０．０１。观察组均术后５ｄ拆线。结论：新式剖宫产术具有缩短胎儿娩出时间，出血少、术后疼痛轻、恢复快、减少住院时间等优点。

Objective: To compare the new method of cesarean section (the Misgav Ladach method) with the traditional Pfannenstiel low segment cesarean section. Methods: 54 cases of the Misgav Ladach method cesarean section were compared with 42 cases of traditional Pfannenstiel low segment cesarean section. The new method includes: the use of Joel Cohen method to open the abdominal wall, closure of incision without suturing the visceral peritoneum and peritoneum,one layer suturing of low transverse uterine incision and closure of the abdominal wall with two to three stitches. Results: The average delivery time of the fetus in the new method was (5±3) min compared with the traditional cesarean section (10±4) min, P <0.01; blood loss was (134±62) ml, versus (193±105) ml, P <0.01;postoperative recovery of the bowel movement was (20±9) hours versus (34±9) hours, P < 0.01 ; postoperative pain was (9±11) hours versus (24±12) hours, P <0.01. In the new method cesarean section sutures of the wound were removed 5 days after operation. Conclusion: The new method cesarean section has the following advantages: faster in deliverying the fetus, less bleeding, less pain,sooner recovery, and less hospital stay, so it is worth spreading.