Nagele F, Karas H, Spitzer D, Staudach A, Karasegh S, Beck A, Husslein P
Department of Obstetrics and Gynecology, University Hospital of Vienna, Austria.
Am J Obstet Gynecol. 1996 Apr;174(4):1366-70. doi: 10.1016/s0002-9378(96)70686-5.
Our purpose was to determine whether nonclosure of the visceral peritoneum at low transverse cesarean delivery has advantages over suture peritonization with regard to postoperative morbidity.
A prospective randomized trial of 549 women undergoing cesarean section was carried out; 262 were randomized to nonclosure and 287 to closure of the visceral peritoneum. Perioperative, intraoperative, and postoperative management decisions were made without reference to treatment groups. Statistical analysis compared intraoperative and postoperative outcome between the two groups.
Operating and anesthesia times were significantly shorter in patients receiving nonclosure. The incidence of febrile morbidity and cystitis and the need for antibiotics and narcotics were all significantly greater when the peritoneum was closed. Hospital stay was significantly shorter after nonclosure.
Nonclosure of the visceral peritoneum is associated with lower febrile and infectious morbidity. Routine closure of the visceral peritoneum should be abandoned at cesarean delivery.
我们的目的是确定低位横切口剖宫产术中不缝合脏腹膜与缝合腹膜化相比在术后发病率方面是否具有优势。
对549例行剖宫产术的女性进行了一项前瞻性随机试验；262例被随机分配至不缝合组，287例被随机分配至缝合脏腹膜组。围手术期、术中及术后的管理决策均不参考治疗组情况。统计分析比较了两组的术中及术后结果。
接受不缝合的患者手术时间和麻醉时间明显更短。缝合腹膜时，发热性疾病、膀胱炎的发生率以及抗生素和麻醉剂的使用需求均显著更高。不缝合后住院时间明显更短。
不缝合脏腹膜与较低的发热和感染发病率相关。剖宫产时应放弃常规缝合脏腹膜。
