多种子宫缝合技术用于治疗产后出血患者的临床研究  

Clinical study of various uterine suture techniques for the treatment of postpartum hemorrhage

作　　者：闫冬丽[1] 张玲[1] 罗琼[1] 张俊丽[1] 陈晓黎[1] 朱晓兰 郭梅[1] YAN Dong-li;ZHANG Ling;LUO Qiong;ZHANG Jun-li;CHEN Xiao-li;ZHU Xiao-lan;GUO Mei(Department of Obstetrics,Guangyuan Central Hospital,Guangyuan 628001,Sichuan,China)

机构地区：[1]广元市中心医院产科,四川广元628001

出　　处：《川北医学院学报》2021年第12期1617-1620,共4页Journal of North Sichuan Medical College

基　　金：四川省广元市科学技术与知识产权局重点研发项目(19ZDYF0103)。

摘　　要：目的:分析多种子宫缝合技术用于治疗产后出血对产妇术后并发症及月经恢复的影响。方法:选取112例产后出血患者为研究对象,根据止血方案不同分为研究组(n=59)和对照组(n=53)。对照组患者给予常规药物治疗联合纱布条或宫腔球囊填充宫腔、子宫按摩,在确认治疗无效后进行手术治疗;研究组患者于确认常规保守疗效不佳后立即给予改良B-Lynch缝合术联合改良Cho缝合术治疗。比较两组患者治疗的有效率及子宫切除率、产后24 h出血量、处理时间、输血比例等,产褥感染、继发性贫血、宫腔粘连等并发症发生率。出院后随访10个月,比较两组患者产后恶露持续时间、产后月经恢复所需时间、月经量恢复所需次数、月经周期。结果:对照组有13例患者(24.52%)治疗无效转行子宫缝合术,其中6例患者(11.3%)最终行子宫切除术;研究组有2例患者(3.39%)治疗无效,最终行子宫切除术。两组患者治疗有效率比较,差异有统计学意义(P<0.05)。剔除上述治疗无效病例后,研究组和对照组最终分别纳入57例和40例患者。研究组患者产后24 h出血量、处理时间、输血比例均低于对照组,各类并发症的发生率低于对照组,恶露持续时间、产后月经恢复所需时间、月经量恢复所需次数、月经周期低于对照组,差异均有统计学意义(P<0.05)。结论:与常规治疗方案比较,产后出血早期采用多种子宫缝合技术进行治疗,在加快止血、减少失血量方面具有更好的疗效,并可降低并发症的发生率、促进产后月经恢复。Objective:To analyze the effects of various uterine suture techniques in the treatment of postpartum hemorrhage ant its effects on postoperative complications and menstrual recovery.Methods:112 cases of postpartum hemorrhage were selected as the research subjects,and they were divided into the study group(n=59)and the control group(n=53)according to the hemostatic scheme.The patients in the control group were given conventional drug therapy combined with gauze or intrauterine balloon filling uterine cavity and uterine massage,and then transferred to surgical treatment after confirming that the treatment was ineffective.The patients in the study group were immediately treated with modified B-Lynch suture combined with modified Cho suture after confirming the poor conventional conservative effects.The effective rate and the hysterectomy rate between the patients in the two groups were compared.After excluding the invalid cases,the effective indicators such as the 24-hour postpartum hemorrhage volume,the treatment time,the blood transfusion rate between the patients in the tow groups were compared.The incidence of complications such as puerperal infection,secondary anemia,intrauterine adhesions were observed and compared between the patients in the two groups.After 10 months of follow-up,the duration of lochia postpartum,the time required for postpartum menstrual recovery,the number of menstrual volume recovery and the menstrual cycle between the patients in the two groups were compared.Results:In the control group,13 patients(24.52%)were invalid and converted to uterine suture,among them,6 patients(11.3%)finally underwent hysterectomy.In the study group,2 patients(3.39%)were ineffective and finally underwent hysterectomy.There were significant differences in the effective rate between the two groups(P<0.05).After excluding the invalid cases,57 patients and 40 patients were included in the study group and the control group respectively.The 24-hour postpartum hemorrhage volume,the treatment time,the blood transfusion

关 键 词：子宫缝合术 产后出血 并发症 月经恢复 

分 类 号：R719.8[医药卫生—妇产科学]