剖宫产术

AIM To study the application of air sac obstetric apparatus in natural vaginal labor and its role in avoiding the conventional cesarean section in abnormal position of fetal head and the breech presentation with normal weight i nfants.

目的 通过对胎头位置异常120例及臀位60例施行气囊助产术研究，可使多数按常规处理应行剖宫产术的胎头位置异常者转化为阴道分娩，还能顺利解决正常体质量之臀位经阴道分娩。

Objective:to investigate the cesarean section of the reasons for the bleeding, and lower the rate of obstetric hysterectomy possibility.methods: 30 cases in our hospital cesarean section in the clinical data of patients with hemorrhage were retrospectively analyzed.results: in 30 cases of bleeding, placental factors accounted for 53.33%, 36.67% of the uterine atony, uterine incision bleeding laceration of 6.67%, 3.33% of the amniotic fluid embolism, hysterectomy three cases.conclusion:placenta, uterine atony cesarean section is the main reason for the bleeding.

目的：探讨剖宫产术中大出血的原因及降低产科子宫切除率的可能性。方法：对我院30例剖宫产术中大出血患者的临床资料进行回顾性分析。结果：30例大出血中，胎盘因素占53.33%，宫缩乏力占36.67%，子宫切口裂伤出血占6.67%，羊水栓塞占3.33%。治疗结果中，子宫切除3例，占剖宫产术的0.076%（3/3 935）。结论：胎盘因素、宫缩乏力是剖宫产术中大出血的主要原因。

New-style analyse palace produces conclusion not to oversew mural layer peritonaeum can make celiac straight flesh and uterus compact adhesion, bring about when the operation enters an abdomen, depart again adhesion time is long, loss of celiac straight flesh is big, adhesion is more traditional the uterus issues paragraph of analyse to produce art serious, to again the operation increased difficulty, what through new-style analyse palace peritonaeum of layer of wall yield art oversews is improved, not only the advantage that retained new-style analyse palace to produce, and the adhesion that block stopped celiac straight flesh and uterine cut, do not disturb especially and injure bladder, do not give again analyse palace is produced bring difficulty, it is a kind of very good new-style analyse palace produces improved art.

结论新式剖宫产不缝合壁层腹膜可使腹直肌和子宫致密粘连，导致再次手术进腹时分离粘连时间长，腹直肌损伤大，粘连较传统子宫下段剖产术严重，给再次手术增加了难度，通过新式剖宫产术壁层腹膜缝合的改良，不但保留了新式剖宫产的优点，而且阻断了腹直肌和子宫切口的粘连，非凡是不扰乱和损伤膀胱，不给再次剖宫产带来困难，是一种很好的新式剖宫产改良术。

Results All cases became amenorrheic during GnRH-α therapy. The enlarged uteri all decreased to normal or near normal size. Menstruation returned in 80～90 days after cessation of treatment. Three cases conceived within four menstrual periods. One of them resulted in the birth of a healthy 3 150 g male at 38 weeks gestation by cesarean section. The second pregnancy resulting after adenomyomectomy was terminated by emergent cesarean section at 30 weeks gestation because of threatened rupture of uterus. The third is now normal at 28 weeks pregnancy .The fourth has had 2 menstrual periods and is still being followed up.

结果 GnRH-α用药期间4例均闭经，血雌二醇于用药的第3周降到绝经期水平；用药6次后增大的子宫缩小至正常或接近正常。1例子宫后壁局限性腺肌瘤未行手术切除者，用药后腺肌瘤缩小73.7%。3例于腹腔镜术后、停药转经的4个月内妊娠；另1例停药转经2个月，现在随访中。3例妊娠转归：1例足月剖宫产分娩；1例手术切除肌壁间腺肌瘤者，孕30周时因先兆子宫破裂急诊行剖宫产术；1例目前孕22周。

Their fecundity outcome were followed-up after cessation of GnRH-α treatment. Results All cases became amenorrheic during GnRH-α therapy. The enlarged uteri all decreased to normal or near normal size. Menstruation returned in 80～90 days after cessation of treatment. Three cases conceived within four menstrual periods. One of them resulted in the birth of a healthy 3 150 g male at 38 weeks gestation by cesarean section. The second pregnancy resulting after adenomyomectomy was terminated by emergent cesarean section at 30 weeks gestation because of threatened rupture of uterus.

结果 GnRH-α用药期间4例均闭经，血雌二醇于用药的第3周降到绝经期水平；用药6次后增大的子宫缩小至正常或接近正常。1例子宫后壁局限性腺肌瘤未行手术切除者，用药后腺肌瘤缩小73.7%。3例于腹腔镜术后、停药转经的4个月内妊娠；另1例停药转经2个月，现在随访中。3例妊娠转归：1例足月剖宫产分娩；1例手术切除肌壁间腺肌瘤者，孕30周时因先兆子宫破裂急诊行剖宫产术；1例目前孕22周。

Anticoagulating reaˉsonably during pregnancy,monitoring PT and APTT and checking mechanical valve in order to avoid valve embolism.Once occuring this complication,the emergency way to save maternal and newborn's lives was to do operation as what said above.

孕期合理应用抗凝药物，严密监测凝血指标及心脏瓣膜功能，尽可能避免瓣膜栓塞，一旦发生，在开胸直视下，同时行子宫下段剖宫产术、子宫次全切除术及心脏瓣膜置换术，不失为抢救母儿生命之急救方法。

Full-term pregnancy of primipara 120 cases of illness; Stochastic double divides into three groups: research of group-A group and B group. control group of C group, A group (n=40), 0.75% levobupivacaine 10mg for CSEA, B group (n=40), 3% chloroprocaine the hard membrane pericoel hinders, C group: 0.75% bupivacaine for under the arachnoidea the cavity hinders the anaesthesia, In surgery process, to A and B groups, 2% lidocaine were intermittently injected respective-ly by epidural cathete, effec not enough of anesthesia.

足月初产妇120例随机双盲分成三组：研究组为A组和B组，对照组为c组。A组(n=40)蛛网膜下腔阻滞麻醉用药为0.75%左旋布比卡因10mg，使用腰麻硬膜外联合阻滞行剖宫产术，B组(n=40)以3％氯普鲁卡因为硬膜外麻醉的局麻药，使用硬膜外麻醉阻滞行剖宫产术，c组(n=40)腰麻用药为0.75%布比卡因10mg，使用腰麻硬膜外联合阻滞行剖宫产术。

Results: 8 cases of patients were vaginal delivery; cesarean section delivery in parallel with hysteromyomectomy were 21 cases;1 case was multiple fibroids and the diameters were＞5 cm, with more bleeding and a larger wound during the operation d, so we took total hysterectomy to avoid infection; 1 case of cervical fibroids, which did not be removed in the cesarean section because of its special position.

结果：患者阴道分娩8例；行剖宫产术分娩并行子宫肌瘤剔除术21例；1例为肌瘤多发，且直径均＞5 cm，术中出血较多，且创面较大，为避免感染和出血行全子宫切除；1例为子宫颈肌瘤，因其特殊位置，剖宫产时未行剔除术。

Objective To study the difference of one-layered suture and two-layered suture of crosscut on the lower uterus of cesarean section and the best suture of uterus cut.Methods Closing the wound of uterus with a continuous suture. Results The operation time of one-layered suture was 27.28 minutes shorter than two-layered suture.The quantity of bleeding is 69.78ml less than two-layered suture.

目的 探讨子宫下段横切口剖宫产术子宫切口单层缝合与双层缝合的差异度，寻找最优的子宫切口缝合方法；方法子宫下段横切口剖宫产子宫切口单层连续锁边缝合；结果单层缝合手术时间，较双层缝合短27 。8min ，出血量较双层缝合少69 。78ml，术后排气时间较双层缝合提前15 。14h ，经统计学处理，两组具有显著性差异（ P＜0 。01）。

BACKGROUND: Prewarming and intraoperative warming with forced air-warming systems prevent perioperative hypothermia and shivering in patients undergoing elective cesarean delivery with epidural anesthesia.

背景：术前和术中使用充气式保温系统能预防硬膜外麻醉行择期剖宫产术患者的围术期低温及寒战。

Breath, muscle contraction of the buttocks; arch body, as far as possible to hold his head, right leg straight towards the ceiling (peg-leg knee in order to avoid muscle tension).

呼气，收缩臀部肌肉；拱起身体，尽量抬起头来，右腿伸直朝向天花板（膝微屈，以避免肌肉紧张）。

The cost of moving grain food products was unchanged from May, but year over year are up 8%.

粮食产品的运输费用与5月份相比没有变化，但却比去年同期高8％。