剖宫产术中难治性大出血的临床治疗探讨  

Clinical investigation of treatment for refractory bleeding in caesarean section

作　　者：姜景玉 

机构地区：[1]河南省宝丰县中医院妇产科,河南宝丰467000

出　　处：《中国当代医药》2013年第7期191-192,194,共3页China Modern Medicine

摘　　要：目的观察子宫动脉上行支结扎及宫腔纱布填塞结合治疗产后出血的临床疗效。方法将本院2009年7月～2012年7月剖宫产术中引起难治性产后大出血的37例患者的治疗方法，如按摩子宫，药物缩宫，子宫动脉上行支结扎术及宫腔纱布填塞术综合治疗，进行观察分析，评定疗效。结果37例研究对象中，有35例患者经以上4步结合治疗，达到有效止血，保留了生育功能。1例死亡，1例切除子宫为保守失败。结论在按摩子宫，缩宫药物应用的基础上，进行子宫动脉上行支结扎术及宫腔纱布填塞术结合治疗难治性宫缩乏力性产后出血及胎盘因素引起的产后出血，是安全简便可行的。Objective To investigate the clinical effects of ascending branch of uterus artery ligation combined with gauze packing in uterine cavity for postpartum hemorrhage. Methods Thirty seven cases of postpartum hemorrhage caused by Caesarean section had been treated in our hospital from July 2009 to July 2012. The efficacy and treatments such as uterus massage, uterine contraction by drugs, ligation of ascending branch of uterus artery and gauze packing in uterine cavity had been observed and analyzed. Results In 37 cases, thirty five cases had been cured by above- mentioned four steps treatments, effectively stopped hemorrhage and retained reproductive function. One case died, 1 case failed of conservative treatment and got hysterectomy. Conclusion Based on uterine massage and applying uterine contraction drugs, ascending branch of uterus artery ligation combined with gauze packing in uterine cavity is safe, easy and feasible for refractory postpartum hemorrhage caused by uterine inertia and placental factors.

关 键 词：子宫动脉上行支结扎 宫腔纱布填塞 宫缩乏力性产后出血 剖宫产术 B—lynch缝合术 改良B—lynch 缝合术及补丁缝合法 子宫次全切除术 

分 类 号：R719.8[医药卫生—妇产科学]