中国实用妇科与产科杂志2024，Vol.40Issue(5)：561-565,5.DOI:10.19538/j.fk2024050117
产科相关肛门括约肌损伤57例临床特征及结局分析
Analysis of clinical characteristics and outcomes of 57 cases with obstetric anal sphincter injuries
摘要
Abstract
Objective Obstetric anal sphincter injuries(OASIS)is a serious complication of vaginal delivery.This study aims to explore the clinical characteristics and perioperative management of patients with OASIS providing refer-ence for clinical management.Methods We reviewed the cases of OASIS during vaginal delivery at the Zhujiang New Town Branch of Guangzhou Women and Children's Medical Center from January 1,2018 to December 31,2022.We summarized the clinical characteristics,perioperative management,and follow-up outcomes.Results The 5-year inci-dence of OASIS was 0.1％(57/40 855),with grade Ⅳ laceration of the perineum accounting for 21.1％(12/57).Primip-ara accounted for 68.4％(39/57)of cases and 17.5％(10/57)were non-anterior occipital deliveries.The episiotomy rate was 38.6％(22/57),the assisted vaginal delivery rates was 29.8％(17/57)and only 4 cases were macrosomia,ac-counting for 7.0％(4/57).One rectal mucosal button-hole injury was diagnosed 28 days after delivery and followed up for six months after repair,resulting in a full recovery.56 cases were diagnosed with OASIS during labor,with 53 re-paired by external anal sphincter end-to-end and three repaired by overlapping.Postoperative intestinal management and broad-spectrum antibiotics were provided.One patient with a grade Ⅳ laceration suffered a rectovaginal fistula,which healed spontaneously after three months of conservative treatment.The remaining patients recovered well.Conclu-sions OASIS often occurs in women with primiparity,vaginal delivery,non-occipital delivery,and macrosomia.Early detection,standardized repair treatment,and perioperative process management are key to successful healing.关键词
产科相关肛门括约肌损伤/临床特征/围术期管理/临床结局Key words
obstetric and sphincter injuries/clinical characteristic/perioperative management/clinical outcome分类
医药卫生引用本文复制引用
王乐乐,刘妍,周蓓,张慧珠,赖毓冕,刘慧姝,郑峥..产科相关肛门括约肌损伤57例临床特征及结局分析[J].中国实用妇科与产科杂志,2024,40(5):561-565,5.基金项目
广东省基础与应用基础粤穗联合青年基金(2020A1515110077) （2020A1515110077）
