腹膜外剖宫产与腹膜内剖宫产的比较

Comparison of extraperitoneal cesarean and intraperitoneal cesarean

目的:探讨腹膜外子宫下段剖宫产术的优越性。方法:对110例腹膜外(腹膜外组)子宫下段剖宫产术和120例传统腹膜内(腹膜内组)子宫下段剖宫产术者的临床资料进行回顾性分析。结果:两种剖宫产术式在年龄、术前血象及术中从切皮到胎儿娩出时间、总手术时间及术中出血量、新生儿Apgar评分方面比较,无显著性差异(P>0.05);但在术后排气时间、下床活动时间、术后抗生素应用时间、术后住院时间等方面比较,有非常显著性差异(P<0.01)。与传统腹膜内子宫下段剖宫产术相比,腹膜外子宫下段剖宫产术有术后排气早、进食早、恢复快等优点。结论:腹膜外子宫下段剖宫产术主要有以下优点:未进行腹腔操作,术后肛门排气快、胃肠功能恢复快、进食早;术后不会发生肠粘连、肠梗阻;术后腹痛轻、营养好,有利于切口愈合;乳汁分泌早,有利于母乳喂养;操作方法简单并能熟练掌握,对医疗设备无特殊要求。该术式值得临床推广应用。

To explore the advantages of extraperitoneal cesarean. Methods： 110 cases of extroperitoneal cesaren （extraperitoneal group） and 120 cases of conventional intraperitoneal （intraperitoneal group） cesarean were compared. Results：The two groups in age, preoperative blood, the time from a skin incision to the baby delivered, the total operative time and blood loss, neonatal Apgar score are compared, there was no significant difference （P〉0.05）, but in exhaust time after the operation, ambulation time, postoperative antibiotic time, postoperative hospital, there was a significant difference （P〈0.01）. The extraperitoneal cesarean compared with traditional intraperitoneal cesarean, there were many advantages, such as the exhaust early, eat early, rapid recovery, and so on. Conclusion： There is no abdominal operations, therefore, the extraperitoneal cesarean has postoperative exhaust fast, faster recovery of gastrointestinal function, eating early, no bowel adhesion and bowel abstruction. Lighter postoperative abdominal pain and good nutrition can be beneficial to incision healing,breastfeeding. And the operation method is no special requirements for medical devices and it is simple to master. It＇s suitable for clinical application.