宫颈提拉式缝合术在特殊剖宫产术中的应用效果  

Application of cervical-lifting suture in special cesarean section

作　　者：刘巧香 王华莉 高立娟 王义娜 Liu Qiaoxiang;Wang Huali;Gao Lijuan;Wang Yina(Department of Obstetrics and Gynecology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院妇产科,平顶山467000

出　　处：《中国实用医刊》2022年第12期56-58,共3页Chinese Journal of Practical Medicine

摘　　要：目的研究宫颈提拉式缝合术在特殊剖宫产术中的临床应用效果。方法抽取2020年6月至2021年6月平煤神马医疗集团总医院妇产科收治的行前置胎盘剖宫产术发生宫颈管顽固性出血患者110例,行宫颈提拉式缝合术治疗。观察纳入患者术中止血效果和产后出血情况,并随访至产后42 d。结果宫颈提拉式缝合术中110例患者均止血成功,止血成功率为100%。术中血浆输入量为(111.39±17.44)ml,红细胞悬液输入量为(428.65±26.08)ml,出血量为(754.22±36.65)ml,止血时间为(17.82±3.60)min;术中、术后监测血压、心率均在正常范围,无子宫切除者;术后24 h阴道出血量(133.26±13.04)ml。术后予以常规补液、抗感染治疗,无盆腹腔感染、切口感染及产褥感染,腹部切口愈合佳,体温正常,产后42 d随访,彩色多普勒超声显示子宫复旧好,子宫切口未见异常回声,妇科检查宫颈外形正常。结论应用宫颈提拉式缝合术治疗前置胎盘剖宫产术宫颈管顽固性出血具有良好的止血效果,且不易出现并发症。Objective To study the application of cervical-lifting suture in special cesarean section.Methods A total of 110 patients with intractable cervical canal bleeding who underwent cesarean section with cervical-lifting suture for placenta previa in Department of Obstetrics and Gynecology of General Hospital of Pingmei Shenma Medical Group from June 2020 to June 2021 were selected.The intraoperative hemostatic effect and postpartum hemorrhage of selected patients were observed.All patients were followed up till 42 days after delivery.Results All of the 110 patients who underwent cervical-lifting suture successfully arrested bleeding,and the success rate of hemostasis was 100%.The intraoperative average infusion volume of plasma was(111.39±17.44)ml,the intraoperative average infusion volume of red cell suspension was(428.65±26.08)ml,the intraoperative blood loss was(754.22±36.65)ml,and hemostasis time was(17.82±3.60)min.The blood pressure and heart rate were within the normal range during and after operation.No patient had requirement of hysterectomy.The vaginal bleeding volume in 24 hours after operation was(133.26±13.04)ml.All patients received routine fluid infusion and anti-infective treatment after operation.No pelvic-abdominal infection,incision infection or puerperal infection was observed.The abdominal incision healed well,and body temperature was normal.After 42 days of postpartum follow-up,color Doppler ultrasound showed that uterine involution was good,no abnormal echo was found in the uterine incision,and the cervical shape was normal in gynecological examination.Conclusions Cervical-lifting suture can achieve good hemostatic effect in the treatment of intractable cervical canal bleeding in cesarean section for placenta previa,with few complications.

关 键 词：宫颈提拉式缝合术 前置胎盘 剖宫产术 宫颈管顽固性出血 

分 类 号：R719.8[医药卫生—妇产科学]