止血带宫颈环扎法在剖宫产产后出血防治中的应用效果  

Effect of Cervical Cerclage by Tourniquet on Prevention and Treatment of Postpartum Hemorrhage of Cesarean Section

作　　者：周文正[1] 程永红[1] 周玮[1] 严宇 Zhou Wenzheng;Cheng Yonghong;Zhou Wei(Department of Obstetrics,Chongqing Health Center for Women and Children,Chongqing 400021,China)

机构地区：[1]重庆市妇幼保健院产科,重庆400021

出　　处：《华中科技大学学报（医学版）》2020年第6期741-744,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：重庆市卫生健康委医学科研资助项目(No.20142098)。

摘　　要：目的研究在剖宫产术中应用止血带宫颈环扎法防治产后出血的效果。方法以2015~2018年重庆市妇幼保健院产科病房剖宫产术中采用了止血带环扎子宫颈的产妇作为观察组,匹配基本信息,符合纳入标准但未采用止血带者作为对照组。回顾性分析研究病例的临床资料,比较观察组和对照组的出血原因、手术时间、产后2 h出血量、产后总出血量、术中输血率、子宫切除率等指标,对止血带环扎子宫颈防治剖宫产产后出血的效果进行评价。结果研究共纳入656例患者,其中观察组351例,对照组305例。应用止血带宫颈环扎法的主要原因是是前置胎盘、瘢痕子宫和子宫收缩乏力。观察组的术后2 h出血量为(387.39±246.17)mL,术后总出血量为(467.24±246.17)mL,对照组分别是(445.30±288.38)mL和(523.08±273.77)mL,两组差异均有统计学意义(均P<0.01);观察组发生术中输血的比例为4.30%,少于对照组的8.20%,差异有统计学意义(P<0.05)。结论止血带宫颈环扎法是降低剖宫产产后出血的有效方式。Objective To investigate the effect of cervical cerclage by tourniquet on prevention of postpartum hemorrhage after cesarean section.Methods A retrospective analysis of clinical data was conducted in Chongqing Health Center For Women and Children from 2015 to 2018.The parturients who met the inclusion criteria and received cervical cerclage by tourniquet after cesarean section were chosen as the observation group;those matched basic information and without the use of tourniquet were selected as the control group.The effect evaluation indexes were analyzed and compared including the causes of bleeding,operation time,amount of bleeding within 2 hours postpartum,the total amount of bleeding,blood transfusion rate,hysterectomy rate between the observation group and the control group.Results Of the 656 patients,351 patients were in the observation group and 305 cases in the control group.Placenta previa,scar uterus and uterine atony were the most frequently causes for using tourniquet.The postoperative blood loss within 2 hour was(387.39±246.17)mL and the total postoperative blood loss was(467.24±246.17)mL in the observation group,and the control group was(445.30±288.38)mL and(523.08±273.77)mL respectively.The ratio of intraoperative blood transfusion in the observation group was 4.30%,less than that(8.20%)of the control group.The difference was statistically significant.Conclusion Cervical cerclage with tourniquet is an effective way to reduce postpartum hemorrhage after cesarean section.

关 键 词：止血带宫颈环扎法 剖宫产 产后出血 

分 类 号：R719.8[医药卫生—妇产科学]