Joel-Cohen切口剖宫产190例临床观察

RANDOMIZED CLINICAL TRIAL OF 190 CASES OF JOEL-COHEN INCISION AT CESAREAN SECTION

目的 :探讨Joel-Cohen切口剖宫产的手术方式及其临床价值。方法 :双侧髂前上棘连线下大约 3cm或下腹部横皱上 2～ 3cm处 ,做一平直横切口 ,横向撕拉皮下脂肪组织、筋膜、腹直肠进行腹膜内及腹膜外剖宫产 ,并与同期传统腹部直切口腹膜内及腹膜外剖宫产进行对照。结果 :190例Joel-Cohen剖宫产 ,切皮至胎儿娩出时间短 ,手术总时间短 ,术中出血少 ,术后排气时间短 ,疼痛轻 ,术后发病率低 ,与对照组比较差异有显著性 (P <0 .0 5 )。结论 :Joel-Cohen切口剖宫产优于传统腹部直切口剖宫产 。

Objective:To evaluate the technique of Joel-Cohen incision at cesarean section & its clinical value.Methods:We made a transverse incision 3cm below linkage of bilateral anterior superior iliac spines or 2～3cm above lower abdomen and transverse wrinkle, and transversely lacerate subcutaneous fat,fascia and straight musle of abdomen, followed by intraperitoneal or extranperitoneal cesarean section.A randomized trial was designed to compare intra and postoperative morbidity between the Joel-Cohen incision and traditional pfannenstiel incision at cesarean section.Results:In 190 cases of Joel-Cohen incision,a shorter opening time(the interval from skin incision to delivery of the child),a shorter operative time (less intraoperative exsufflation time), less pain and lower postoperative morbidity were observed than the control group.Conclusions:Joel-Cohen incision is better than traditional pfannenstiel incision at cesarean section.This technique is worthy of clinical application.