子宫动脉上行支结扎联合止血带治疗凶险型前置胎盘出血的效果评价  

Effect Evaluation of Ligation of Uterine Artery Ascending Branch Combined with Tourniquet for Pernicious Placenta Previa Hemorrhage

作　　者：陈志梅[1] CHEN Zhimei(Shenzhen Maternal and Child Health Hospital,Shenzhen 518000,China)

机构地区：[1]广东省深圳市妇幼保健院,广东深圳518000

出　　处：《中国医学创新》2020年第13期69-72,共4页Medical Innovation of China

摘　　要：目的:研究子宫动脉上行支结扎联合止血带治疗凶险型前置胎盘出血的临床效果。方法:选取2015年1月-2017年1月本院妇产科收治的86例凶险型前置胎盘患者为研究对象。采取计算机随机数字分组法将患者分为两组,每组43例。对照组采取常规方法进行胎盘处理,观察组在胎盘处理前先实施子宫动脉上行支结扎,并利用止血带止血。比较两组患者的手术时间、术中出血量、术前及术中生命体征变化情况、术中低体温发生率、子宫切除率、输血率、产后出血量、宫底下降速度、恶露持续时间。结果:两组的手术时间比较,差异无统计学意义(P>0.05);观察组的术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组的术中低体温发生率、子宫切除率、输血率均明显低于对照组,差异均有统计学意义(P<0.05)。手术中,观察组的收缩压、舒张压、心率、体温均较手术前有轻微下降,但下降幅度不明显(P>0.05)。手术中,对照组的收缩压、舒张压、心率、体温均显著低于手术前,且均低于观察组,差异均有统计学意义(P<0.05)。观察组的产后2、24 h出血量均少于对照组,差异均有统计学意义(P<0.05)。观察组的宫底下降速度快于对照组,恶露持续时间短于对照组,差异均有统计学意义(P<0.05)。结论:在凶险型前置胎盘出血患者胎盘处理前对其进行子宫动脉上行支结扎,联合应用止血带,可有效减少患者术中及产后出血量,有利于维持患者生命体征稳定,减少子宫切除,加快产后恢复。Objective: To study the clinical effect of ligation of ascending branch of uterine artery combined with tourniquet in the treatment of pernicious placenta previa hemorrhage. Method: A total of 86 patients with pernicious placenta previa admitted to the department of obstetrics and gynecology of our hospital from January 2015 to January 2017 were selected as the research objects. Patients were randomly divided into two groups by computer random number grouping method, 43 cases in each group. The control group received conventional placental treatment, in the observation group, the ascending branch of uterine artery was ligated and tourniquet was used for hemostasis before the treatment of placenta. The operative time, intraoperative blood loss, preoperative and intraoperative changes in vital signs, intraoperative hypothermia incidence, uterine resection rate, blood transfusion rate, postpartum blood loss, uterine basal decline rate, lochia duration were compared between the two groups. Result: There was no significant difference in operation time between the two groups(P>0.05). Intraoperative blood loss in the observation group was less than that in the control group, the difference was statistically significant(P<0.05). The incidence of intraoperative hypothermia, uterine resection and blood transfusion in the observation group were significantly lower than those in the control group, with statistically significant differences(P<0.05). During the operation, the systolic blood pressure, diastolic blood pressure, heart rate and body temperature of the observation group all decreased slightly compared with those before the operation, but the decrease was not obvious(P>0.05). During the operation, the systolic blood pressure, diastolic blood pressure, heart rate and body temperature of the control group were significantly lower than those before the operation and lower than those in the observation group, with statistically significant differences(P<0.05). The postpartum blood loss of the observation group at 2 and

关 键 词：凶险型前置胎盘 产后出血 子宫动脉上行支结扎 止血带 

分 类 号：R714.2[医药卫生—妇产科学]