改良式腹膜外剖宫产术临床分析

Clinical analysis of modified extraperitoneal cesarean section

目的 :评价改良式腹膜外剖宫产术的优点。方法 :选择有剖宫产指征的孕妇 1 6 5例 ,随机分为两组 ,1 0 6例作改良式腹膜外剖宫产术 (腹膜外组 ) ,5 9例作腹膜内剖宫产术 (腹膜内组 ) ,然后观察及比较两组产妇术中 (从手术开始到胎儿娩出所用的手术时间、总手术时间、术中出血量 )和术后(胃肠功能恢复、伤口疼痛及愈合等 )情况。结果 :腹膜外组从不间断切皮至胎儿娩出时间及总手术时间与腹膜内组比较 ,差异无显著性 (P均 >0 .0 5 ) ,而两组术中出血量相比较则差异有显著性 (P <0 .0 1 ) ;腹膜外组术后病率 (发热、伤口疼痛及腹胀等 )明显少于腹膜内组 ,两组比较差异均有显著性 (P均<0 .0 1 )。结论 :改良式腹膜外剖宫产术具有切口美观、可防止腹腔粘连、感染 ,术后恢复快等优点 ,值得推广应用。

Objective: To evaluate the virtues of modified extraperitoneal cesarean section. Methods: 165 pregnant women with indications of cesarean section were divided randomly into extraperitoneal group (106 cases) operated by modified extraperitoneal cesarean section and intraperitoneal group(59 cases) by intraperitoneal cesarean section, then the situation of pregnant women in two groups were observed and compared, including the operation time from the beginning to childbirth, total operation time, the blood amount in the cesarean section, recovery of gastrointestinal function after operation, the pain and healing of postoperative wound etc. Results: There was not significant difference between two groups in the time from continuous skin incision to childbirth and total operation time(P>0.05). There was significant difference between two groups in the blood amount in the cesarean section(P<0.01). The incidence of a disease of extraperitoneal group(including fever, pain of wound and distension etc.) was significant less than which of intrapetritoneal group, they had significant difference(P<0.01). Conclusion: The modified extraperitoneal cesarean section was worthy of clinical application because of its beautiful cut, prevention of intraabdominal adhesion and infection, quick recovery etc.