论文部分内容阅读
例1.26岁.因孕足月,扁平骨盆,头盆不称住当地卫生院行子宫体部剖宫产术,术后8天拆线,切口Ⅰ期愈合.术后第19个月,患者突然恶心、呕吐,剧烈腹痛.腹部检查,脐下可见纵行手术疤痕,疤痕上端有指甲大的圆形瘘孔,水肿肉芽外翻,探之有5.5cm深,靠其左侧能触到一个不规则的包块,有压痛.妇检:宫体鸭卵大,前位,宫底及左侧宫旁有较厚的软组织粘连,并与前腹壁固定,触痛明显,剖腹探查术中发现大网膜、回肠中段、子宫前壁与前腹壁广泛粘连.行粘连大网膜切除,回肠切除10cm,行端端吻合,然后顺着腹壁瘘管一直剔到子官前壁,瘘管底部波及到子宫体及峡部,,行子宫次全切除术.术中见7号丝线线结成团堆积在哆开的宫壁右侧。线结间夹杂着少许
Case 1.26 years of age due to pregnancy full-term, flat pelvis, head basin does not live in the local hospital cesarean section of the uterus, stitches removed after 8 days, incision healed I. 19 months after the patient suddenly Nausea, vomiting, severe abdominal pain. Abdominal examination, visible under the umbilical longitudinal surgical scars, scars have a large round fistula nails, edema granulation valgus, exploration of 5.5cm deep, by its left to touch a not Rules of the mass, tenderness. Gynecological examination: Palace duck eggs large, anterior, palace and the left side of the uterus with thick soft tissue adhesions and anterior abdominal wall fixed, tenderness, laparotomy found large Omentum, the middle of the ileum, the anterior wall of the uterus and the anterior abdominal wall extensive adhesions line adhesions omentum resection, ileal resection 10cm, line end anastomosis, and then along the abdominal wall fistula has been ticked to the anterior wall, fistula bottom spread to the uterus And the isthmus, line subtotal hysterectomy surgery see No. 7 silk line group formed in the dull open the right side of the wall. Line between the mixed with a little