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分娩时产伤达肛管、直肠及阴道中下段的贯穿伤比较罕见.临床经验不足的医师在处理时是一个棘手的问题,我院遇到一例,报道如下。患者29岁,1981年5月11日足月分娩,胎儿娩出时头手复合先露,于会阴5点处切开,产一男婴,重3,900g,产后即发现会阴体、肛管、直肠及阴道中下段呈较整齐的纵向裂开,裂口上方达腹膜反折下约2cm,直肠后壁及壶腹部敞开,直肠前壁裂伤在齿状线以上约7cm,肛管短约1.5cm,会阴体短约2cm,伤道内出血较多。处理:先用1‰新洁尔灭液将伤道进行彻底冲洗消毒,牵拉宫颈后唇,然后按照由内向外、从后向前的顺序,用0号肠线依解剖层次将直肠粘膜、直肠阴道隔膜、阴道粘膜依次往返对位间断缝合,各粘膜面针距约1cm,边距约0.5cm,缝合对位要平整,线结宜避开伤口,肛门内、外括约肌、会阴深、浅横肌及海绵体肌的缝合用中号丝线注意断端对合良好,最后丝线
Birth injury up to the anal canal during childbirth, rectal and vaginal penetration of the middle and lower section is relatively rare.Mathematically inexperienced physicians in dealing with a difficult problem, our hospital encountered a case reported below. Patient 29 years old, May 11, 1981 full-term childbirth, first hand when the fetus was delivered first compound exposed at the perineum at 5 o’clock cut to produce a baby boy, weighing 3,900 g, found after delivery perineal body, anal canal, rectum and The middle and lower vagina was more neat longitudinal split, the top of the gap up to about 2cm peritoneal reflex, the posterior wall of the rectum and ampulla open, anterior rectal wall laceration in the dentate line above about 7cm, the anal canal is short about 1.5cm, perineum Short body about 2cm, more bleeding wounds. Treatment: First with 1 ‰ Bromogeramine solution to the wound thoroughly washed and disinfected, pulling the posterior lip of the cervix, and then in accordance with the order from the inside out, from back to front, with 0 gut according to the anatomical level of the rectal mucosa, rectovaginal septum , The vaginal mucosa followed by turn back and forth on the intermittent suture, the mucosal surface needle about 1cm, margin of about 0.5cm, suture alignment should be smooth, the line should avoid the wound, anus, external sphincter, perineal and superficial muscle Cavernous muscle suture with a medium-sized thread to pay attention to stitched together well, the last thread