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剖宫产术:低位横切口(耻骨联合上横切口)还是正中切口?(作者译)

[Caesarean section: low transverse (pfannenstiel) or midline incision? (author's transl)].

作者信息

Hetzel H, Bichler A, Geir W, Dapunt O

出版信息

Z Geburtshilfe Perinatol. 1979 Apr;183(2):128-35.

PMID:35886
Abstract

In 67 elective Caesarean sections and 70 emergency sections the effect of the duration of anaesthesia upon the condition of the newborn was examined. The induction-delivery time (IDT), the operation time (OT), and the difference between these, delta t, were correlated with the 1-, 5- and 10-minute Apgar scores and the pH's of the venous and arterial umbilical cord blood. A highly significant negative association was found for the pH in the umbilical vein and delta t in the series of primary sections. Analysis of the emergency sections showed a negative association between the operation time and the 5 minute Apgar score, and a positive association between the delta t and 1 minute Apgar score. Despite these findings we have observed that the induction-delivery time which we are able to achieve in our hospital has no negative effect upon the biochemical condition (pH) of the newborn. A comparison of 619 sections performed by low midline incision with 328 section by Pfannenstiel incision showed no difference with regard to postoperative complications such as disturbance in wound healing or haematoma formation. In conclusion, with respect to the IDT and postoperative complications we have found no contraindication to the use of the low transverse Pfannenstiel incision for Caesarean section.

摘要

在67例择期剖宫产和70例急诊剖宫产中,研究了麻醉持续时间对新生儿状况的影响。诱导-分娩时间(IDT)、手术时间(OT)以及两者之差δt,与1分钟、5分钟和10分钟阿氏评分以及脐静脉和脐动脉血的pH值相关。在初次剖宫产系列中,发现脐静脉pH值与δt之间存在高度显著的负相关。对急诊剖宫产的分析显示,手术时间与5分钟阿氏评分之间呈负相关,而δt与1分钟阿氏评分之间呈正相关。尽管有这些发现,但我们观察到,我院能够达到的诱导-分娩时间对新生儿的生化状况(pH值)没有负面影响。对619例经低位中线切口剖宫产与328例经Pfannenstiel切口剖宫产进行比较,结果显示在伤口愈合障碍或血肿形成等术后并发症方面无差异。总之,就诱导-分娩时间和术后并发症而言,我们未发现剖宫产采用低位横切口Pfannenstiel切口有任何禁忌证。

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