横切口左侧入式腹膜外剖宫产术临床应用

Clinical application of extraperitoneal cesarean section modified by left - sideway separation with transverse incision

目的探讨横切口左侧入式腹膜外剖宫产术的临床价值。方法对本院行横切口左侧入式腹膜外剖宫产术50例（腹膜外组）及同期选取新式子宫下段剖宫产术50例（新式组）做对照分析，对两组手术效果、术后并发症、术后恢复情况及新生儿评分等进行对比。结果腹膜外组与新式组患者的平均手术时间、平均胎儿娩出时间、平均术后排气时间、术后病率、平均术后疼痛时间、腹胀患者比例分别为（40±4．7）min、（12±5．5）min、（24±2．2）h、10％、（15．5±2．2）h和18％及（25±3．5）min、（5±2．2）min、（48±4．5）h、30％、（30．6±2．8）h和52％，两组的差异均有统计学意义。腹膜外组和新式组术中出血量分别为（160±32）ml和（154±30）ml，差异无统计学意义。Apgar评分5～7分、8～10分者，腹膜外组分别占8％（4／50）和92％（46／50），新式组分别占12％（6／50）和88％（44／50），差异无统计学意义。结论横切口左侧入式腹膜外剖宫产术创伤小，对机体干扰小，术后恢复快，可以推广。

Objective To study the clinic advantage of extraperitoneal cesarean section modified by left-sideway separation with transverse incision. Methods Fifty cases with extraperitoneal cesarean section modified by left-sideway separation with transverse incision, and 50 cases with new method cesarean section were selected to compare the effect of operation, postoperative complications, postoperative recovery and the Apgar score of the newborns between the two groups. Results The average overall time of operation, average duration from the skin incision and getting the fetus head out, average postoperative period of breaking wind, postoperative mobidity, average postoperative pain time and abdominal distention of the extraperitoneal cesarean section modified by left-sideway separation group was （40 ± 4.7 ） min, （12 ± 5.5 ） min, （24±2.2） h, 10 %, （15.5±2.2） h, and 18 %, respectively, and （25±3.5） min, （5 ±2.2） rain, （48±4. 5） h, 30 %, （30.6 ± 2.8） h, and 52 %, respectively in the new method cesarean section group. The amount of blood loss of the two groups were （ 160 ± 32） ml and （ 154 ± 30） ml, respectively. The proportion of the Apgar score of the new- borns with 5-7 points and 8-10 points of the extraperitoneal cesarean section modified by left-sideway separation group was 8 % （4/50） and 92 % （46/50）, while the other group was 12 % （6/50） and 88 % （44./50）, respectively. Conclusion Extraperitoneal cesarean section modified by left-sideway separation with transverse incision is a safe, convenient and easy-to-master operation.