替代难治性产后出血子宫切除的晨笛网压缝合术的有效性  

Effectiveness of Chendi netlike compression suture instead of hysterectomy in treatment of intractable postpartum hemorrhage

作　　者：李莉[1] 王晨笛[1] 李南 钟英 雷颖 尹学琼[5] 何丛妍 

机构地区：[1]成都市第五人民医院妇产科,四川成都611130 [2]成都市妇女儿童中心医院,四川成都610091 [3]成都市金堂纺织医院,四川成都610404 [4]成都市温江区妇幼保健院,四川成都611130 [5]崇州市妇幼保健院,四川崇州611230 [6]成都市大邑县人民医院,四川成都611300

出　　处：《中国妇幼保健》2016年第7期1535-1538,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);成都市科学技术局成都市科技惠民技术研发(2014-HM01-00330-SF);成都市卫生局卫生科研重大攻关项目(2014044)

摘　　要：目的探讨晨笛网压缝合术(Chendi netlike compression suture,CNCS)在难治性产后出血中常规方法治疗无效后替代子宫切除术的有效性。方法回顾性分析采用CNCS对5例难治性产后出血患者的治疗,评价其疗效及安全性。结果 5例患者行CNCS后,子宫活动性出血5~15 min停止,阴道无流血后关腹,均成功保留子宫。MRI检查显示:术后4 d宫壁见散在点状信号,术后46d宫壁肌层信号均匀,宫内膜线清晰;超声检查显示:术后42d宫壁肌层回声均匀,复旧形态良好;随访结果为:5例患者术后42 d复查,恶露均已净,停止哺乳后1~2个月经恢复正常。其中1例患者于术后20个月再次妊娠,29个月后经剖宫产诞下一健康女婴。结论 CNCS在难治性产后出血治疗中具有重要应用价值,对经常规药物及手术治疗无效患者,应果断选择CNCS进行急救以挽救患者子宫。Objective To explore the effectiveness of Chendi netlike compression suture （CNCS） instead of hysterectomy in treatment of intractable postpartum hemorrhage when traditional therapy fails. Methods Five cases with intractable postpartum hemorrhage treated by CNCS were analyzed retrospectively, the curative effect and safety were evaluated. Results After CNCS, active uterine bleeding stopped within 5-10 minutes, the surgery was completed when vaginal bleeding was stopped, their uteri were all successfully reserved. MRI showed that there were scattered punctiform signals in the uterine wall on the fourth day after surgery, uniform signals of uterine n^usele layer and clear endometrium line were observed on the 46th day after surgery. Ultrasonic examination showed that there were uniform echoes of uterine muscle layer, uterine morphology returned to normal. Lochia had been clean when they were reviewed at 42 days after surgery. All the women resumed normal menstruation at 1-2 months after the cessation of breastfeeding. One patient got pregnancy 20 months later and gave birth to a healthy girl safely after 29 months by cesarean section. Conclusion CNCS has important application value in treatment of intractable postpartum hemorrhage, CNCS should be conducted as soon as possible to reserve their uteri when traditional medicine and surgery are ineffective.

关 键 词：产后出血 子宫缝合术 晨笛网压缝合术 有效性 

分 类 号：R719.1[医药卫生—妇产科学]