止血带捆扎子宫下段血流阻断术在前置胎盘剖宫产术中的应用  

Hemostasis efficacy of tourniquet binding of the lower uterine segment in patients with placenta previa undergoing Caesarean section

作　　者：颜云华[1] 张爱华[1] 李宁[1] 郦培昕 戴楠[1] YAN Yunhua;ZHANG Aihua;LI Ning(Department of Obstetrics and Gynecology,Danyang People's Hospital,Danyang 212300,CHINA)

机构地区：[1]丹阳市人民医院妇产科,江苏212300

出　　处：《江苏医药》2020年第9期939-941,共3页Jiangsu Medical Journal

摘　　要：目的探讨止血带捆扎子宫下段血流阻断术在前置胎盘剖宫产患者的应用效果。方法前置胎盘行剖宫产术患者80例随机分为两组,每组40例。胎儿娩出后,A组使用止血带捆扎子宫下段止血,B组采取通常的宫腔水囊压迫止血。止血效果不佳者行子宫动脉结扎术,止血失败的行子宫切除术。比较两组止血效果及手术相关指标。结果A组剖宫产术中顺利止血,无子宫切除病例;B组2例止血不成功需实施子宫切除,子宫切除率为5.0%。A组产后出血发生率低于B组(2.5%vs.15.0%)(P<0.05)。A、B组新生儿窒息发生率相仿(5.0%vs.7.5%)(P>0.05)。A组剖宫产手术时间为(54.12±6.41)min,短于B组的(65.56±7.23)min(P<0.05)。A组术中出血量为(741.12±123.36)mL,少于B组的(1221.15±241.15)mL(P<0.05)。结论与宫腔水囊压迫止血法比较,前置胎盘行剖宫产术中采用止血带捆扎子宫下段血流阻断术可取得更好的止血效果,减少手术出血量,降低子宫切除率及产后出血发生率。Objective To observe the hemostasis efficacy of tourniquet binding of the lower uterine segment in the patients with placenta previa undergoing Caesarean section.Methods Eighty patients with placenta previa were randomly divided into two groups with 40 cases each.To stop bleeding after fetal delivery,tourniquet binding of the lower uterine segment was used in group A and conventional water capsule uterine cavity compression was used in group B.Uterine artery ligation was performed when necessary and uterine hysterectomy was performed in the patients with uncontrollable bleeding.The results of hemostasis and operation-related indexes were compared between the two groups.Results Bleeding during Cesarean section was controlled smoothly without hysterectomy case in group A.Hysterectomy was performed in 2 cases(5.0%)of group B because of uncontrollable bleeding.The incidence of postpartum haemorrhage was lower in group A than that in group B(2.5%vs.15.0%)(P<0.05).The incidence of neonatal asphyxia in group A was similar to that in group B(5.0%vs.7.5%)(P>0.05).The time for Caesarean section was shorter in group A than that in group B[(54.12±6.41)minutes vs.(65.56±7.23)minutes](P<0.05).Surgical blood loss was less in group A than that in group B[(741.12±123.36)mL vs.(1221.15±241.15)mL](P<0.05).Conclusion Compared with conventional water capsule uterine cavity compression hemostasis,tourniquet binding of the lower uterine segment in the patients with placenta previa undergoing Caesarean section has the advantages of better hemostasis efficacy,less surgical blood loss,and lower rates of hysterectomy and postpartum haemorrhage。

关 键 词：前置胎盘 子宫下段止血带捆扎 宫腔水囊压迫 剖宫产 

分 类 号：R719[医药卫生—妇产科学]