半腹膜外剖宫产术50例临床分析.docVIP

半腹膜外剖宫产术50例临床分析 【关键词】 剖宫产术；半腹膜外；腹膜外半腹膜外剖宫产术50例临床分析 (pdf) ［摘要］ 目的 探讨优化腹膜外剖宫产术式和减少手术并发症的方法。方法 100例有剖宫产手术指征的孕妇随机分为两组：半腹膜外组50例，腹膜外组50例。半腹膜外组采用半腹膜外剖宫产术式，腹膜外组采用腹膜外剖宫产术式。结果 半腹膜外组胎儿娩出困难需产钳助产率为4%，腹膜外组为30%，两组比较差异有统计学意义（P0.01）；半腹膜外组一过性血尿发生率为4%，腹膜外组为26%，两组比较差异有统计学意义(P0.05)；半腹膜外组和腹膜外组在手术时间、术中出血量、术后病率、排气时间、新生儿1 min Apgar评分5～7分、新生儿平均体重方面差异无统计学意义。结论 半腹膜外剖宫产术同样具有腹膜外剖宫产术的不干扰腹腔脏器，术后反应轻、并发症少的优点，还有手术方法简单、胎儿娩出迅速、膀胱损伤小、能探查附件的优点。 ［关键词］ 剖宫产术；半腹膜外；腹膜外 Semi-clinical analysis of 50 cases of cesarean section LUO Wen-qun，JIAO Ya-jing.Department of Obstetrics and Gynecology Jiangxi Provincial People’s Hospital，Nanchang 330006 China ［Abstract］ Objective Optimization partly extraperitoneal cesarean section operation and reduce surgical complications.Methods 100 cases of pregnant women were randomly divided into two groups : group partly extraperitoneal 50 cases，50 cases extraperitoneal.Partly extraperitoneal group semi-cesarean section，extraperitoneal group cesarean section surgery.Results Partly extraperitoneal need forceps delivery rate of 4%，30% extraperitoneal group，the difference between the two groups was statistically significant (P0.01).Partly extraperitoneal transient hematuria in a group rate to 4%，extraperitoneal group 26%，the difference between the two groups was statistically significant(P0.05).There was no significant differences in the operative time，blood loss，postoperative infection rate，exhaust，newborn one-minute Apgar score 5～7，neonatal weight in two groups.Conclusion Partly extraperitoneal cesarean section has same non-interference abdominal viscera，mild postoperative reaction.The advantage of fewer complications，surgical method is simple，rapid delivery of the fetus，bladder injury，the advantages of the annex that can detect. ［Key words］ cesarean section；partly extraperitoneal；extraperitoneal 腹膜外剖宫产是利用解剖上的特点而创造出的一种剖宫产手术，这一手术主要是用于有宫内感染或潜在感染的产妇。同时还具有术后肠蠕动恢复较快，腹痛也远较子宫下段剖宫产者轻。但在长期的临床实践中，特别是对于年轻医生来说，其难点在于在腹膜外需正确分离膀胱子宫反折腹膜，否则易发生胎头娩出困难及一过性肉眼血尿或膀胱损伤。为了克服腹膜外剖宫产术式的缺点，保留其优点，2005年1月～