乏力性产后出血两种保守性治疗策略的临床疗效比较  

Comparison of clinical effects of two conservative strategies in treatment of atonic postpartum hemorrhage

作　　者：王晨笛[1] 李兰[1] 李南 除世康 刘莉[1] 刘颖[1] 卢小红[1] 李莉[1] 韩倩[1] 李莉琼[1] 刘帅[1] 雷颖 尹学琼[4] 何丛妍 

机构地区：[1]四川省成都市第五人民医院,611130 [2]四川省成都市妇女儿童中心医院 [3]四川省成都市温江区妇幼保健院 [4]四川省崇州市妇幼保健院 [5]四川省成都市大邑县人民医院

出　　处：《中国妇幼保健》2015年第21期3567-3570,共4页Maternal and Child Health Care of China

基　　金：四川省卫生和计划生育委员会科研课题〔150023〕;四川省成都市科学技术局成都市科技惠民技术研发项目〔2014-HM01-00330-SF〕;四川省成都市卫生局卫生科研重大攻关项目〔2014044〕

摘　　要：目的比较两种治疗策略下乏力性产后出血的临床疗效，探讨晨笛网压缝合术（CNCS）在治疗乏力性产后出血中的应用价值。方法回顾性分析2011年1月～2014年12月成都市第五人民医院临床资料完整的乏力性产后出血患者175例，其中行CNCS的为实验组，共89例；其余86例为对照组。对比两组治疗效果及保守性手术术中和术后情况。结果实验组患者全部保留子宫（100．0％），对照组81例患者（94．2％）保留子宫，两组比较差异有统计学意义（P〈0．05）。两组术前出血量比较，差异无统计学意义（t=0．175，P〉0．05）；实验组术中出血量及总出血量均小于对照组，差异有统计学意义（t=23．376，P〈0．05；t=16．351，P〈0．05）；实验组手术时间短于对照组，差异有统计学意义（t=6．771，P〈0．05）；实验组术后输血、术后转ICU及住院天数均小于对照组，差异均有统计学意义（P〈0．05）。保守性治疗进入子宫缝合后，两组止血成功率比较差异有统计学意义（P〈0．05）。结论CNCS较经典的B—Lynch缝合术更具有临床治疗优势，尤其适合医疗条件有限的广大基层医院开展。CNCS强化了抉择主动性，更具临床操作性，对保留产妇生育功能具有重要意义。Objective To compare the clinical effects of two conservative strategies in treatment of atonic postpartum hemorrhage, explore the application value of Chendi netlike compression suture （CNCS） in treatment of atonie postpartum hemorrhage. Methods A total of 175 atonic postpartum hemorrhage patients with intact clinical data were selected from the hospital from January 2011 to December 2014 and analyzed retrospectively, then the patients were divided into experimental group （89 patients） and control group （86 patients）, the pa- tients in experimental group underwent CNCS. The curative effects, intraoperative and postoperative situations in the two groups were com- pared. Results In experimental group, all the patients （100. 0% ） preserved uteri; in control group, 81 patients （94. 2% ） preserved uteri, there was statistically significant difference between the two groups （P〈0. 05） . There was no statistically significant difference in the amount of blood loss before surgery between the two groups （t = 0. 175, P〉0. 05 ） ; the amounts of blood loss during operation and the total a- mount of blood loss in experimental group were statistically significantly less than those in control group （ t = 23. 376, P〈0.05 ; t = 16. 351, P 〈0. 05 ） ; the operation time in experimental group was statistically significantly shorter than that in control group （t = 6. 771, P〈0. 05 ） ; the numbers of postoperative blood transfusion and transfer treatment to ICU, and hospitalization time in experimental group were statistically sig- nificantly lower than those in control group （P〈O. 05 ） . After uterine suture, there was statistically significant difference in the successful rate of hemostasis between the two groups （ P〈0. 05 ） . Conclusion Compared with classical B-Lynch suture, CNCS has its advantages in clinical treatment, CNCS is especially suitable for the basic hospitals with limited medical condition, it enhances the initiative of choice, has clinical maneuverability and i

关 键 词：产后出血 策略 晨笛网压缝合术 

分 类 号：R714.461[医药卫生—妇产科学]