宫颈提拉缝合联合子宫动脉结扎治疗凶险性前置胎盘术中顽固性出血的临床分析  

Cervical Suspension Suture Combined with Uterine Artery Ligation for Intractable Hemorrhage during Operation for Dangerous Placenta Previa

作　　者：曾萌[1] 秦竞霞[1] 王婷[1] ZENG Meng;QIN Jing-xia;WANG Ting(Department of Obstetrics,Foshan Maternal and Child Health Hospital,Foshan 528000,China)

机构地区：[1]佛山市妇幼保健院产科,广东佛山528000

出　　处：《实用临床医学（江西）》2020年第5期46-48,共3页Practical Clinical Medicine

摘　　要：目的分析宫颈提拉缝合联合子宫动脉结扎治疗凶险性前置胎盘术中顽固性出血的临床效果。方法对佛山市妇幼保健院2018年2月至2019年2月收治的30例凶险性前置胎盘剖宫产术中发生顽固性出血患者的临床资料进行回顾性分析,其中凶险性前置胎盘Ⅰ型5例、Ⅱ型7例、Ⅲ型12例、Ⅳ型6例,均采用宫颈提拉缝合联合子宫动脉结扎治疗。结果30例患者术中出血量500~5000 mL,平均(1552±1248)mL;输血浆(577±341)mL,输血红细胞(5.23±3.47)U;手术时间(87.54±23.86)min;术中未出现因出血过多需切除子宫的患者。术后阴道出血量48.55~306.41 mL,平均(165.67±23.85)mL;住院时间(5.25±1.56)d。术后定期随访,11例患者月经量相比于术前明显增加,17例患者恢复状况良好,2例失访;无术后并发症发生。结论宫颈提拉缝合联合子宫动脉结扎应用于顽固性出血的凶险性前置胎盘手术,能够起到快速止血的作用,降低术中因大出血需切除子宫的概率,临床应用效果良好。Objective To analyze the clinical efficacy of cervical suspension suture combined with uterine artery ligation in intractable hemorrhage during operation for dangerous placenta previa.Methods Clinical data of 30 patients treated in Foshan Maternal and Child Health Hospital between February 2018 and February 2019 for intractable hemorrhage during operation for dangerous placenta previa were analyzed retrospectively.Cervical suspension suture combined with uterine artery ligation were performed in all the 30 patients with dangerous placenta previa,including typeⅠin 5,typeⅡin 7,typeⅢin 12,and typeⅣin 6.Results The average intraoperative blood loss,plasma transfusion volume,erythrocyte transfusion volume,operation time,postoperative vaginal blood loss and hospital stay were(1552±1248)mL(range 500-5000 mL),(577±341)mL,(5.23±3.47)U,(87.54±23.86)minutes,(165.67±23.85)mL(range 48.55-306.41 mL)and(5.25±1.56)days,respectively.No patients underwent intraoperative hysterectomy due to excessive bleeding and had postoperative complications.Regular follow-up showed that 11 patients had increased menstrual volume and 17 patients achieved good recovery.Two patients were lost to follow-up.Conclusion Cervical suspension suture combined with uterine artery ligation can quickly stanch bleeding and reduce the probability of needing hysterectomy due to massive hemorrhage in the treatment of intractable hemorrhage during operation for dangerous placenta previa.

关 键 词：宫颈提拉缝合 子宫动脉结扎 顽固性出血 凶险性前置胎盘 临床分析 

分 类 号：R714[医药卫生—妇产科学]