【Abstract】ObjectiveTo investigate the effects of high molecular bio-degradable film on preventing peritoneal adhesion. MethodsOne hundred and twenty rats were divided into control group, non-bio-degradable film group and polycaprolactone (PCL) group. Animal models of peritoneal adhesion made by operations on rats serve as control group. In the study, non-bio-degradable film and biodegradable, namely PCL films sensitive to pseudomonas enzyme, were put into the opening of peritoneum. The effect of the films on peritoneal adhesion was examined on 1, 3, 7 and 30 d after operation. ResultsPeritoneal adhesion was found in all the rats of control group and very low in PCL group and non-bio-degradable film group. ConclusionPCL film can effectively prevent the formation of postoperative peritoneal adhesion.
Objective To explore the value of lower abdominal aorta compression in emergent hysterectomy during cesarean section because of pernicious placenta previa. Method We retrospectively analyzed the clinical data of four patients who underwent hysterectomy for pernicious placenta previa with the assistance of lower abdominal aorta compression between January 2016 and March 2017 in Sichuan Provincial Hospital for Women and Children. Result The four patients were cured successfully, and the mothers and babies were all well with no pelvic organ damage or complications related to lower abdominal aorta compression. Conclusions Lower abdominal aorta compression in hysterectomy for pernicious placenta previa during cesarean section is a feasible procedure; it can effectively reduce the amount of bleeding, less affect maternal blood circulation, make surgery area clear, and give the operators the chance to do hysterectomy calmly. Lower abdominal aorta compression presents more and more advantages to treat pernicious placenta previa and may be an effective emergency measure to reduce hemorrhage during perioperative period especially under the circumstances of no chance to carry out vascular intervention treatment.
Objective To compare the outcome of uterine exteriorisation repair with in situ in caesarean section. Methods A randomized controlled trial with 220 cases were recruited. Woman with term singleton pregnancy underwent caesarean section and without severe complication were randomly allocated to the two groups (112 cases in exteriorisation group and 108 cases in situ group). Women in treatment group received exteriorisation when the uterus was sutured, While others had the uterus repaired in situ as control. Main outcome measures included perioperative haemodynamic parameters, loss of blood, changes in haemoglobin concentration, duration of operation, postoperative pain score and febrile days, gastrointestinal discomforts and function recovery as well as postoperative maternal morbidity.Data were analyzed by SPSS 11.0. Results Haemoglobin concentration dropped in both groups after caesarean section, and the drops in control group was significantly higher than that of treatment group (t=-2.902, P=0.004). In both groups, pulse before operation was markedly higher than when suturing the uterus and postoperation (Plt;0.05), but no difference was observed between the two groups. Systolic blood pressure of treatment group was lower than that of control group before operation, when suturing the uterus and after operation (F=5.246, P=0.022), but there was no difference among these 3 time points within the group. Onset of flatus was earlier in control group than in treatment group (t=5.567, P=0.000). No difference was identified between the two groups when receiving the different suturing methods. No severe maternal morbidity was observed.Conclusions Uterine exteriorisation and in situ repair have similar effects on intra- and postoperative outcomes. In routine process.
Objective To study the clinical significance of the microorganism culture result of amniotic fluid in cesarean section in the treatment of anti-infection after operation. Methods From August 2016 to May 2017 in Women’s and Children’s Hospital of Sichuan Province, 502 amniotic fluid samples were collected in cesarean section to carry out bacteria culture. The correlations between the amniotic fluid culture result and the preoperative and intraoperative risk factors and the correlations between postoperative infection and the preoperative and intraoperative risk factors were analyzed. Results In the 502 amniotic fluid samples, there were 131 samples culture-positive. The microbiological culture results of amniotic fluid were statistically different between the puerperae with gestational age<37 weeks and the ones with gestational age≥37 weeks (P=0.001). Postoperative infection occurred in 6 puerperae, in whom the amniotic fluid culture results were positive in 3 puerperae. There was no statistical difference in the occurrence of postoperative infection between the puerperae with amniotic fluid culture-positive results and the ones with negative results (P=0.382). The occurrence of postoperative infection was associated with preoperative infections, gestational age, using time of antimicrobial, and preoperative rupture of membranes (P<0.05). Conclusions The contamination rate of amniotic fluid specimen was high, which was of low reference value to anti-infection treatment after operation. When an extension of anti-infection treatment be carried out after cesarean section, suitable specimens should be selected according to the infection site.