膀胱镜检查并输尿管插管在剖宫产术中应用效果分析.docVIP

膀胱镜检查并输尿管插管在剖宫产术中应用效果分析 　　[摘要]目的 探讨膀胱镜检查在切口延裂或出血剖宫产术中应用的安全性及可行性。方法 选择2014年1月～2016年12月在我院行剖宫产术时发生子宫切口延裂明显或切口出血丰富，行缝扎近宫颈处的患者60例进行回顾性分析。膀胱镜检查并输尿管插管为研究组；常规输尿管解剖位置检查，未行膀胱镜检查并输尿管插管的为对照组；分析比较两组手术时间、出血量、输尿管缝扎、二次手术、术后感染及并发等情况。结果 与对照组相比，研究组手术耗时显著缩短[（50±10）min vs.（60±10）min] （P=0.0003），研究组术中出血量较对照组显著更少[（300±20）ml vs.（350±30）ml]（P=0.0000）。术后输尿管缝扎及二次手术发生数均显著更少（P=0.0166，P=0.0303），术后并发症与对照组比较，差异无统计学意义（P0.05）。结论 在需要缝合近宫颈处的剖宫产术中，应用膀胱镜检查并输尿管插管，可以缩短手术时间，降低输尿管缝扎及二次手术发生的风险。 　　[关键词]剖宫产术；切口延裂；膀胱镜；输尿管插管 　　[中图分类号] R713 [文献标识码] A [文章编号] 1674-4721（2017）12（b）-0080-03 　　[Abstract]Objective To investigate the safety and feasibility of cystoscopy in cesarean section that delayed dehiscence or postpartum hemorrhage.Methods Retrospective analysis of 60 patients which sutued cervix becaused of delayed dehiscence or rich bleeding in cesarean section from January 2014 to December 2016 in Ruijin Maternal and Child Health Care Hospital.Patients who underwent intraoperative cystoscopy combined with ureter catheterization were considered as research group.Patients who just underwent routine detection of ureter anatomical location were considered as control group.And the operation time，bleeding volume，suture of ureter，cond operation，postoperative infection and complications were analyzed and compared between the two groups.Results Compared with the control group，operation time was significantly shortened in the research group [（50±10） min vs. （60±10） min]（P=0.0003） and intraoperative bleeding was significantly less [（300±20） ml vs. （350±30） ml]（P=0.0000）.Postoperative suture and second operation were significantly happened less in research group（P=0.0166，P=0.0303），The postoperative complications were compared with the control group， and the difference was not statistically significant （P0.05）.Conclusion Combination intraoperative cystoscopy withureter catheterization may reduce shorten the operation time and reduce the risk of ureteral ligation and second operation in the cesarean section that requiri