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慢性子宫内翻者由于翻出时间过久,宫颈已形成缩窄环,一般需进行经阴式或腹式子宫切开复位术或子宫切除术。我院1986年对一例产后子宫完全内翻3月余之患者,经阴道徒手复位同时进行子宫颈管缝缩术取得成功。现报告如下。术式介绍术前全身应用抗生素,阴道局部以1:5000呋喃西林液灌洗后,用链霉素粉喷撒于翻出之子宫内膜表面。手术当日禁食,清洁灌肠。采用鞍麻同时静滴杜冷丁50mg,非那根25mg、阿托品1mg。取截石位,常规消毒外阴,先用0.5%洗必太液,再用温盐水充分冲洗阴道及翻出之宫内膜。术者用手指掌面托住翻出之子宫宫底,顺产道轴方向徐徐上推,同时以手指压迫接近宫颈之子宫部分,使其形成一环沟(图1),用单叶窥器暴露宫口,再以4把宫颈钳钳夹宫颈外口3、6、9、12点处。于宫颈窄缩环内注入1%奴佛卡因20ml 加肾上腺素5滴,使宫颈逐渐松软。宫颈窄缩环逐渐扩张后,再用食、中指进入宫口,向上一点一点地加压,使环形沟逐渐加深。当大部分宫体已复位只剩下宫底时,用10号Hegar 氏扩宫器抵住宫底内面,反
Chronic uterine turn due to turn out for too long, the cervix has formed a narrowing ring, the general need for transvaginal or abdominal hysterectomy or hysterectomy. Our hospital in 1986 on a case of postpartum uterus completely inverted more than 3 months of patients, vaginal manual reduction at the same time cervical suture shrinkage achieved success. The report is as follows. Preoperative surgical application of antibiotics, vaginal topical 1: 5000 nitrofurazone solution lavage, streptomycin powder sprayed out of the endometrial surface. The day of surgery fasting, cleansing enema. Sedative anesthesia while taking pethidine pethidine 50mg, non-root 25mg, atropine 1mg. Take lithotomy position, routine disinfection of the vulva, first with 0.5% must wash too liquid, and then warm water to fully wash the vagina and puffed out of the endometrium. The operator with the palm of your hand prop up the uterus turned out the end of the palace, along the axis of the birth slowly push the way, while the finger pressure close to the uterine part of the cervix, making it a ring groove (Figure 1), with single speculum exposure Miyaguchi, and then 4 cervical forceps clamp cervix outside the mouth at 3,6,9,12 points. Into the cervix narrowing ring into the 1% novocaine 20 ml adrenaline 5 drops, so that the cervix gradually soft. Cervical narrowing ring gradually expanded, and then eat, middle finger into the cervix, a little upward pressure, so that the annular groove gradually deepened. When most of the Palace of the body has been reset leaving only the bottom of the Palace, with No. 10 Hegar’s dilator against the inner surface of the palace, anti