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目的 探讨改良式新式剖宫产与传统的子宫下段剖宫产在术式、手术指征、手术时间、胎儿娩出时间、切口撕裂、术中出血及术后恢复等方面的差异。方法 采用了以色列Toel-Cohen开腹方式,钝性撕开脂肪及腹直肌,纵形撕开壁层腹膜,钝性撕开膀胱反折腹膜,子宫下段切口上下方向钝性撕开,术中缝合应用美国氰胺公司生产的DG缝合线,用一根线依次全层缝合子宫下段,不缝合子宫反折腹膜和壁层腹膜。另一根线连续缝合浅筋膜及2/3层皮下脂肪,不打结折回皮内缝合皮肤,留线头5 cm。术后不拆线。结果 本术式术后排气时间由原来的48±5 h缩短至6±5 h,(P<0.01)术后疼痛时间由原来的24±1 h缩短至2±1 h,切口均Ⅰ期愈合。结论 此术优于传统的子宫下段剖宫产,明显缩短了手术时间,胎儿娩出时间,无切口撕裂,减少了产后出血,术后疼痛轻,下床活动早,排气快,术后切口不拆线,无硬结,术后病率少,疤痕纤细,切口美观,易于掌握,值得推广。
Objective To explore the differences between the modified new cesarean section and the traditional lower uterine cesarean section in surgical procedures, operation indications, operation time, fetal delivery time, incision laceration, intraoperative bleeding and postoperative recovery. Methods Israel Toel-Cohen laparotomy, blunt tear open adipose and rectus abdominis, longitudinal tear the parietal peritoneum, blunt tear open the bladder reverse peritoneum, lower uterine incision in the upper and lower incision blunt dissection, intraoperative Stitching the use of the United States Cyanamide DG suture production line, followed by a line with a full-thickness suture the lower uterine segment, uterine peritoneal and parietal perforation is not sutured. Another line of continuous suture superficial fascia and 2/3 subcutaneous fat, not knot fold back skin sutured the skin, leaving the first 5 cm. Postoperative stitches. Results The postoperative exhaust time of this procedure was shortened from 48 ± 5 h to 6 ± 5 h (P <0.01), and the postoperative pain time was shortened from 24 ± 1 h to 2 ± 1 h. The incisions were stage Ⅰ heal. Conclusions This technique is superior to traditional uterine cesarean section, significantly shortening the operation time, fetal delivery time, no incision and tear, reducing postpartum hemorrhage, postoperative pain, bed ambulation early, fast exhaust, postoperative incision Not stitches, no induration, less postoperative morbidity, scar slender, beautiful incision, easy to grasp, it is worth promoting.