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episiotomy

妇产

关键词妇产 手术操作 分娩助产

词汇介绍

拓展阅读

解析

episiotomy   英 [ɪˌpiːsiˈɒtəmi]  美 [ɪˌpiːsiˈɑːtəmi]

释    义   n. [妇产]会阴切开术

例    句   The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery. 会阴侧切术对阴道分娩后骨盆底组织功能的影响。

概述

产道是胎儿分娩的必经之路,产道又分骨产道和软产道,在阴道与肛门之间的软组织称会阴,会阴体则是阴道口到肛门之间的软组织,它们都是软产道的一部分。会阴切开术是产科最为常用的临床操作之一。2000年,大约33%的阴道分娩产妇行会阴切开术。传统观点认为会阴切开术旨在促进第二产程的完成进而改善母儿妊娠结局。认为施行会阴切开术可以降低母体会阴损伤、以后的盆底功能障碍以及脱垂、尿失禁、大便失禁以及性生活障碍的风险。对胎儿潜在的好处包括由于自然分娩进程加快或阴道助产而导致的第二产程缩短。虽然研究数据有限,但

Episiotomy in modern clinical practice: friend or foe?复制标题

现代临床实践中的会阴切开术: 朋友还是敌人?

发表时间:2019-03-13

影响因子:2.1

作者: Maurizio Serati

期刊:International Urogynecology Journal

Episiotomy is one of the most commonly performed surgical procedures in medicine. The Cochrane library first published a meta-analysis in 2000 on the role of the episiotomy in modern clinical practice that concluded that only a policy of selective episiotomy is acceptable with evidence-based improvement in maternal health compared with routine episiotomy. An update of this review in 2008 confirmed the same conclusions. Ten years later, however, the new version of the Cochrane meta analysis changed the previous recommendations in that the selective use of episiotomy could not be considered beneficial in all cases, although there is no clear evidence that this approach would result in harm to mother and baby. What are the advantages of selective versus routine episiotomy? Is there a difference between the complications of medio-lateral and midline procedures? What are the reasons for the recent change in the recommendations of Cochrane’s review? It seems timely to revisit this debate by urogynecologists to give a balanced and evidence-based opinion on whether or not episiotomy is routinely indicated at vaginal birth and whether the benefits and risks of medio-lateral versus the midline procedures are different.

译文

会阴切开术是医学上最常用的手术之一。cochrane图书馆于2000年首次发表了一份关于会阴切开术在现代临床实践中的作用的荟萃分析,该分析的结论是,与常规会阴切开术相比,只有选择性会阴切开术的政策才是可接受的,且产妇健康的循证改善是可接受的。2008年对这一审查的更新证实了同样的结论。然而,10年后,cochrane meta分析的新版本改变了先前的建议,即选择性使用会阴切开术在所有情况下都不能被认为是有益的,尽管没有明确的证据表明这种方法会对母亲和婴儿造成伤害。选择性会阴切开术与常规会阴切开术的优点是什么?中外侧手术和中线手术的并发症有区别吗?Cochrane的审查建议最近发生变化的原因是什么?对于会阴切开术是否是阴道分娩的常规指征,以及侧卧位与中线手术的益处和风险是否不同,泌尿妇科医师重新讨论这一争论似乎是及时的,以给出一个平衡的、基于证据的观点。