经腹宫颈环扎术用于瘢痕子宫术中止血的临床研究  

Clinical study of trans-abdominal cervical cerclage for hemostasis during scar uterus

作　　者：李永胜 陈先侠 卢晓倩 鲍丹丹 钱警语 任俊娇 Li Yongsheng;Chen Xianxia;Lu Xiaoqian;Bao Dandan;Qian Jingyu;Ren Junjiao(Department of Critical Illness Obstetric,Anhui Province Maternity&Child Health Hospital,Anhui Hefei 230001,China;Department of Obstetrics,Anhui Province Maternity&Child Health Hospital,Anhui Hefei 230001,China;Department of VIP Obstetrics,Anhui Province Maternity&Child Health Hospital,Anhui Hefei 230001,China;Science and Education Division,Anhui Province Maternity&Child Health Hospital,Anhui Hefei 230001,China)

机构地区：[1]安徽省妇幼保健院危急重产科,安徽合肥230001 [2]安徽省妇幼保健院产科,安徽合肥230001 [3]安徽省妇幼保健院VIP产科,安徽合肥230001 [4]安徽省妇幼保健院科教处,安徽合肥230001

出　　处：《中国医刊》2022年第3期293-295,共3页Chinese Journal of Medicine

基　　金：安徽省2018年重点研究与开发计划(1804h08020295)。

摘　　要：目的探讨经腹宫颈环扎术用于瘢痕子宫术中止血的临床研究。方法选取2019年1月1日至2019年12月31日在安徽省妇幼保健院危急重产科住院行择期剖宫产术的瘢痕子宫产妇127例,根据止血方法分为研究组(77例)和对照组(50例),研究组采用宫颈环扎术治疗子宫下段薄弱处出血,对照组采用其他常规止血方法治疗子宫下段薄弱处出血,比较两组患者产后出血量、产褥感染、术后住院天数等。结果研究组术中出血量、术后2h出血量、术后24h总出血量均明显低于对照组,差异均有显著性(P<0.05);两组患者的术后血红蛋白水平、抗感染药物使用时间、住院天数比较差异均无显著性(P>0.05)。所有患者术后均无产褥感染、晚期产后出血、子宫切除等严重并发症的发生,产后42d门诊随访盆腔彩色多普勒超声均未见明显异常影像学表现。结论经腹宫颈环扎术可明显减少瘢痕子宫剖宫产术中出血量,操作相对简易,是一种有效的剖宫产术中止血技术,值得在临床上使用。Objective To explore the clinical study of cervical cerclage for hemostasis in scar uterus.Method 127 women with scarred uterus who underwent elective cesarean section in the Department of Critical Illness Obstetric of Anhui Province Maternity&Child Health Hospital from January 1,2019 to December 31,2019 were selected.Cervical cerclage was used to stop bleeding in the lower part of the uterus as the study group(77 cases),used other conventional hemostatic methods as the control group(50 cases).The differences in postpartum hemorrhage,postpartum hemorrhage rate,puerperal disease rate,and postoperative hospital stay were compared between the two groups.Result The intraoperative blood loss in the study group,postoperative 2h blood loss,postoperative 24h total amount of bleeding were lower than the control group,the difference between the two groups was statistically significant(P<0.05).There was no significant difference in postoperative hemoglobin level,anti-infective drug use time and hospital stay between the two groups(P>0.05).All patients had no serious complications such as puerperal infection,late postpartum hemorrhage,and hysterectomy.Conclusion Transabdominal cervical cerclage can significantly reduce the amount of bleeding during scar uterine surgery,and the operation is relatively simple.It is an effective technique for hemostasis during cesarean section,and it is worthy of further promotion in clinical use.

关 键 词：瘢痕子宫 宫颈环扎术 产后出血 预防出血 剖宫产术 

分 类 号：R719.8[医药卫生—妇产科学]