宫颈裂伤10例临床分析

Clinical analysis of 10 cases of cervical laceration

目的:探讨宫颈裂伤原因、临床表现、处理操作方法。方法:一经确诊立即缝合,采用1号可吸收线间断缝合,第一针应超过裂口顶端约0.5cm处进针,最后一针距宫颈口外侧端0.5cm处进针。结果:10例均自然临产,其中7例头位分娩,有5例在第一产程活跃期时静脉滴注缩宫素;2例因胎儿窘迫行阴道助产,3例臀位分娩行臀牵引术。裂伤部位,2例发生于宫颈口3点处;4例发生于宫颈口9点处;3例发生于宫颈口3点和9点处;1例发生于宫颈前唇环形裂伤。结论:严格掌握使用缩宫素的适应症和缩宫素的剂量、浓度和滴速,防止宫缩过强和急产。一定要待宫口开全后,再行臀牵引术、胎头负压吸引助产或产钳助产。

Objective：To study the reasons,clinical manifestation and treatment method of cervical laceration. Methods：Once diagnosed, suture should be performed immediately. The cleft was sutured with absorbable thread （ No. 1 ）, and the first stitch should be over the apex of cleft 0.5cm, and the last one should be over the lateral end of cervical dilation 0.5 cm. Results： All parturients had spontaneous labor. There were 7 cases with head delivery, and 5 parturients were treated with intravenous drip of oxytocin during the time of active phase of labor, and 2 parturients with vaginal assistant labor for the reason of fetal distress,and 3 parturients with assisted breech delivery and breech extraction. As the laceration site of cervix,2 cases was at 3 oclock of cervix, 4 cases at 9 ocleek,and 3 cases at the 3 oclock and 9 oclock, and 1 cases was at the labium anterius with a ring laceration. Conclusion：The indication, dose, concentration and dripping speed should be strict controlled in order to prevent uterine over - efficiency and precipitate labor. The breech extraction, delivery by negative pressure aspiration or forceps must be performed when the uterine neck whole opened.