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1、·CesareanSectionOperativeReport剖宫产手术记录PreoperativeDiagnosis:术前诊断1.23yearoldG1P0,estimatedgestationalage=40weeks23岁G1P0，估计孕周402.Dystocia难产3.Non-reassuringfetaltracing不确定PostoperativeDiagnosis:Sameasabove术后诊断：同前TitleofOperation:Primarylowsegmenttransversecesareansection手术名称：首次子宫下段横切口剖宫产Surgeon:术者Ass
2、istant:助手Anesthesia:Epidural麻醉：硬膜外FindingsAtSurgery:术中所见：Maleinfantinocciputposteriorpresentation.男婴，枕后位Thinmeconiumwithnonebelowthecords,pediatricspresentatdelivery,APGAR's6/8,weight3980g.Normaluterus,tubes,andovaries.稀薄胎粪，分娩时有儿科医生陪伴。阿氏评分1分钟6分，5分钟8分，体重3980g。子宫、卵管、卵巢正常。DescriptionofOperativeProced
3、ure:手术过程描述：Afterassuringinformedconsent,thepatientwastakentotheoperatingroomandspinalanesthesiawasinitiated.Thepatientwasplacedinthedorsal,supinepositionwithleftlateraltilt.Theabdomenwaspreppedanddrapedinsterilefashion.得到（麻醉师）确认许可后，患者进入手术室，应用腰麻。患者采用仰卧左倾斜位，腹部准备，无菌覆盖。APfannenstielskinincisionwasmade
4、withascalpelandcarriedthroughtothelevelofthefascia.ThefascialincisionwasextendedbilaterallywithMayoscissors.ThefascialincisionwasthengraspedwiththeKocherclamps,elevated,andsharplyandbluntlydissectedsuperiorlyandinferiorlyfromtherectusmuscles.用手术刀行凡能斯提尔切口（耻骨上腹部横行半月状切口），穿过筋膜层。用Mayo剪刀向两侧延长切口。Kocher钳夹
5、持筋膜切口，提起，然后钝性上下分离腹直肌。Therectusmuscleswerethenseparatedinthemidline,andtheperitoneumwastentedup,andenteredsharplywithMetzenbaumscissors.Theperitonealincisionwasextendedsuperiorlyandinferiorlywithgoodvisualizationofthebladder.腹直肌被从中间分开，腹膜自动膨出，用Metzenbaum剪刀锐性剪开。在看清膀胱的基础上，上下延长腹膜切口。Abladderbladewasthen
6、inserted,andthevesicouterineperitoneumwasidentified,graspedwiththepick-ups,andenteredsharplywiththeMetzenbaumscissors.Thisincisionwasthenextendedlaterally,andabladderflapwascreated.Thebladderwasretractedusingthebladderblade.Theloweruterinesegmentwasincisedinatransversefashionwiththescalpel,thenext
7、endedbilaterallywithbandagescissors.Thebladderbladewasremoved,andtheinfantsheadwasdeliveredatraumatically.Thenoseandmouthweresuctionedandthecordclampedandcut.Theinfantwashandedofftothepediatrician.Cordgasesandcor
