剖宫产术：腹膜缝合还是不缝合？一项关于术后发病率的随机试验
[Caesarean section: closure or non-closure of peritoneum? A randomized trial of postoperative morbidity].
作者信息
Huchon C, Raiffort C, Chis C, Messaoudi F, Jacquemot M-C, Panel P
机构信息
Service de gynécologie-obstétrique, hôpital André-Mignot, centre hospitalier de Versailles, 177, rue de Versailles, 78157 Le-Chesnay cedex, France.
出版信息
Gynecol Obstet Fertil. 2005 Oct;33(10):745-9. doi: 10.1016/j.gyobfe.2005.08.001.
OBJECTIVE
To evaluate postoperative morbidity with non-closure of the visceral and parietal peritoneum during caesarean section.
PATIENTS AND METHODS
A prospective randomized study of 170 patients. Operative time, postoperative pain, postoperative morbidity (febrile morbidity, wound haematoma, wound infection, postoperative ileus) and length of hospital stay were compared between the two groups.
RESULTS
Duration of operation was significantly shorter without peritoneal closure (38.89 vs 42.00 minutes; P<0.05). Wound haematoma were more frequent when peritoneum was closed (P<0.029). There were no significant difference between the two groups for postoperative ileus, length of hospital stay, postoperative pain and other complications.
DISCUSSION AND CONCLUSION
We report the first French study on this subject. In this study, non-closure of both visceral and parietal peritoneum is associated with shorter operation duration and seems to reduce immediate complications. A long-term evaluation of morbidity, regarding adhesions is necessary.
目的
评估剖宫产术中不缝合脏腹膜和壁腹膜的术后发病率。
患者与方法
对170例患者进行前瞻性随机研究。比较两组的手术时间、术后疼痛、术后发病率（发热性疾病、伤口血肿、伤口感染、术后肠梗阻）及住院时间。
结果
不缝合腹膜时手术时间明显更短（38.89分钟对42.00分钟；P<0.05）。缝合腹膜时伤口血肿更常见（P<0.029）。两组在术后肠梗阻、住院时间、术后疼痛及其他并发症方面无显著差异。
讨论与结论
我们报告了法国关于该主题的第一项研究。在本研究中，不缝合脏腹膜和壁腹膜与较短的手术时间相关，且似乎能减少近期并发症。有必要对粘连相关的发病率进行长期评估。
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