国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (3): 309-311.doi: 10.12280/gjfckx.20241002

• 产科生理及产科疾病: 病例报告 • 上一篇    下一篇

阴道分娩直肠扣眼裂伤一例

刘持稳, 韦静()   

  1. 225300 江苏省泰州市,南京医科大学附属泰州人民医院(泰州市人民医院)妇产科
  • 收稿日期:2024-11-06 出版日期:2025-06-15 发布日期:2025-06-19
  • 通讯作者: 韦静 E-mail:qlm_weijin@163.com

A Case Report of Rectal Buttonhole Tear by Vaginal Delivery

LIU Chi-wen, WEI Jing()   

  1. Department of Obstetrics and Gynecology, The Affiliated Taizhou People′s Hospital of Nanjing Medical University (Taizhou People′s Hospital), Taizhou 225300, Jiangsu Province, China
  • Received:2024-11-06 Published:2025-06-15 Online:2025-06-19
  • Contact: WEI Jing E-mail:qlm_weijin@163.com

摘要:

会阴裂伤是阴道分娩的常见并发症,临床上以Ⅰ度、Ⅱ度会阴裂伤较为常见,Ⅲ度及Ⅳ度会阴裂伤发生率低。直肠扣眼裂伤是一种阴道分娩的特殊罕见并发症。报告1例南京医科大学附属泰州人民医院收治的经阴道分娩并发直肠扣眼裂伤的病例,该患者分娩时发生胎儿手臂贯穿会阴体,分娩后行阴道裂伤修补术+直肠修补术,术后予抗生素预防感染、调整饮食结构、伤口充分置管引流,未发生直肠阴道瘘、切口裂开等并发症,痊愈出院。回顾性分析该患者的诊治经过并复习相关文献,以期总结临床诊治直肠扣眼裂伤的经验。

关键词: 分娩并发症, 病例报告, 阴道分娩, 直肠扣眼裂伤, 会阴裂伤

Abstract:

Perineal laceration is a common complication of vaginal delivery. Clinically, first- and second-degree perineal lacerations are more common, while the incidence of third- and fourth-degree perineal lacerations is low. Rectal buttonhole tear is a special and rare complication of vaginal delivery. This paper reports a case of rectal buttonhole tear complicated with vaginal delivery admitted to Taizhou People′s Hospital affiliated to Nanjing Medical University. During the patient′s delivery, the fetus′ arm penetrated the perineal body. After delivery, vaginal laceration repair and rectal repair were performed. Postoperatively, antibiotics were given to prevent infection, the diet structure was adjusted, and sufficient tube drainage was set for the wound. Complications such as rectovaginal fistula and wound dehiscence did not occur, and the patient was cured and discharged. The diagnosis and treatment process of this patient was retrospectively analyzed, and relevant literature was reviewed to summarize the clinical experience in the diagnosis and treatment of rectal buttonhole tear.

Key words: Obstetric labor complications, Case reports, Vaginal delivery, Rectal buttonhole tear, Perineal laceration