改良外倒转术在横位剖宫产术中的临床应用

Clinical application of modified external inversion in transverse cesarean section

目的探讨改良外倒转术在横位剖宫产术中应用的安全性和有效性。方法将汉中市人民医院2015年2月至2022年10月收治的51例因横位行剖宫产术孕妇按照随机数字表法分为两组,研究组(25例)在剖宫产术中进入腹腔后先行改良外倒转术后切开子宫取胎,对照组(26例)在常规剖宫产术切开子宫人工破膜后行内倒转术取胎。比较两组术中胎儿娩出时间、倒T型切口发生率、术中出血量、Apgar评分、新生儿脐血分析、术中合并症、手术时间、新生儿体重、术后住院时间等情况。结果两组5 min Apgar评分、术中合并症、手术时间、新生儿体重、术后住院时间等资料比较,差异无统计学意义(P>0.05)。相比于对照组,研究组胎儿娩出时间更短、术中出血量更少、1 min Apgar评分更高、新生儿脐血分析更优,差异均有统计学意义(P<0.05)。且研究组术中未出现倒T型切口,而对照组中出现6例(23.1%),差异有统计学意义(P<0.05)。结论横位剖宫产术中采用改良外倒转术具有更高的安全性及优越性,值得临床推广。

Objective Exploring the safety and efficacy of modified external inversion in transverse cesarean section.Methods 51 pregnant women who underwent cesarean section due to transverse position in Hanzhong Peoples Hospital from February 2015 to October 2022.were divided into two groups according to the random number table method,the study group(25 cases)underwent modified external reversal after entering the abdominal cavity during cesarean section,and then the uterus was incised to retrieve the fetus,and the control group(26 cases)underwent internal inversion surgery to retrieve fetuses after conventional cesarean section and artificial rupture of the uterine membrane.Compared the intraoperative fetal delivery time,incidence of inverted T incision,intraoperative bleeding volume,Apgar score,neonatal umbilical artery blood gas analysis,intraoperative comorbidities,operative time,neonatal weight,and postoperative hospital stay between the 2 groups.ResultsThere were no statistically significant differences in 5-minute Apgar score,intraoperative comorbidities,operative time,neonatal weight,and postoperative hospital stay between the 2 groups(P>0.05).Compared with the control group,the time of fetal delivery was significantly shorter,intraoperative bleeding volume was less,1-minute Apgar score was higher,and umbilical artery blood gas analysis was better in the study group,all with a statistically significant difference(P<0.05).And no intraoperative inverted T incision in the study group while 6 cases in the control group(23.1%),with a statistically significant difference(P<0.05).Conclusion The use of modified external inversion in transverse cesarean section has higher safety and superiority and is worthy of clinical promotion.