Lassey A T
Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana.
Int J Gynaecol Obstet. 2007 Nov;99 Suppl 1:S47-50. doi: 10.1016/j.ijgo.2007.06.025. Epub 2007 Sep 17.
Obstetric fistulas occur in developing countries because of the scarcity or complete absence of obstetric services. The magnitude of the problem is unknown but thought to be sizeable. This article describes a basic approach to the care of women with fistulas in a low-resource rural hospital in northern Ghana, where the results were similar to those obtained at better-equipped centers. The facility includes an outpatient clinic for history taking and clinical examinations, and a laboratory for hemoglobin concentration assessment, sickling test, blood grouping, and cross-matching when necessary. Anesthesia consists of a spinal anesthesia given by the surgeon and monitored by a nurse while the surgeon scrubs up before repairing the fistula. Surgery is performed with the patient in exaggerated lithotomy position, and a bed sheet used as a sling prevents her from falling backwards. The patients are kept at the hospital for 14 days postoperatively for continuous bladder drainage.
由于缺乏或完全没有产科服务，产科瘘在发展中国家时有发生。该问题的严重程度尚不清楚，但据认为规模很大。本文描述了在加纳北部一家资源匮乏的农村医院对患有瘘管的妇女进行护理的基本方法，其结果与在设备更好的中心所取得的结果相似。该设施包括一个用于病史采集和临床检查的门诊诊所，以及一个用于评估血红蛋白浓度、镰状细胞检测、血型鉴定和必要时交叉配血的实验室。麻醉由外科医生进行脊髓麻醉，并由一名护士在外科医生在修复瘘管前进行刷手消毒时进行监测。手术时患者采用夸张的截石位，用床单作为吊带来防止她向后摔倒。患者术后在医院留院14天进行持续膀胱引流。
