宫颈多重缝扎术在中央性前置胎盘致剖宫产后剥离面难治性出血中的应用研究  

Application study of multiple cervical suture in patients with stripping surface refractory hemorrhage after cesarean section caused by placenta previa centralis

作　　者：王莉[1] 王瑜[1] 梁菲[1] 陶涛[1] 王焕萍[1] 武海英[1] WANG Li;WANG Yu△;LIANG Fei;TAO Tao;WANG Huanping;WU Haiying(Department of Obstetrics,Henan Provincial People′s Hospital,Zhengzhou,Henan 450003,Chin)

机构地区：[1]河南省人民医院产科,郑州450003

出　　处：《重庆医学》2018年第15期2024-2026,2031,共4页Chongqing medicine

基　　金：2013年度河南省医学科技攻关计划项目(201303160)

摘　　要：目的观察宫颈多重缝扎术在中央性前置胎盘剖宫产术中出现难治性产后出血时的止血效果及其安全性。方法选择2012年1月至2015年12月该院因中央性前置胎盘剖宫产术中发生胎盘剥离面难治性出血患者23例,行宫颈多重缝扎术;另取2008年1月至2011年12月同种患者术中行常规止血方法处理21例为对照。对比两组手术时间、术中术后出血量、子宫切除、术后恢复情况等。结果观察组患者手术时间、术中术后出血量、输血量及子宫切除率均明显低于对照组(P<0.05);术后产妇切口感染及恶露持续时间、月经恢复时间及月经量等情况与对照组比较差异均无统计学意义(P>0.05)。结论宫颈多重缝扎术应用于前置胎盘剖宫产术中胎盘剥离面难治性出血止血效果好,近期随访无并发症,值得临床推广应用。Objective To explore the efficacy and safety of multiple cervical suture in treating stripping surface intractable hemorrhage after cesarean section in the patients with placenta previa centralis. Methods Twenty-three patients with stripping surface intractable hemorrhage during cesarean section caused by placen-ta previa centralis from January 2012 to December 2015 in this hospital were selected and conducted multiple cervical suture , and 21 patients with the same disease undergoing intraoperative conventional hemostasis meth-od from January 2008 to December 2011 served as the control group. The operation time , intraoperative and postoperative blood loss volume , red blood cell transfusion, hysterectomy and postoperative recovery were compared between the two groups .Results The operation time ,intraoperative and postoperative blood loss volume ,blood transfusion volume and hysterectomy rate in the observation group were significantly less than those in the control group（ P〈0. 0 5）, while There were no statistical difference in the aspects of postoperative incision infection, bloody lochiorrhea persisting time ,menstrual recovery time and menstrual volume between the two groups （ P〉0. 0 5） .Conclusion The application of multiple cervical suture in the treatment of strip-ping surface intractable hemorrhage after cesarean section in the patients with placenta previa centralis has better hemostatic effect, had no complications in short term follow up and is worthy clinical promotion and ap-plication.

关 键 词：产后出血 宫颈多重缝扎术 剖宫产术 前置胎盘 

分 类 号：R714.259[医药卫生—妇产科学]