子宫下段横向环形缝合在产后出血中的应用  

Application of transverse circular suture of lower uterine segment in postpartumhemorrhage

作　　者：李晨洁 梁菁苹[2] 王川红[2] Li Chen-jie;Liang Jing-ping;Wang Chuan-hong(Department of Obstetrics and Gynecology,Dancheng Maternal and Child Health Hospital,Zhoukou 477150,Henan,China;Department of Obstetrics,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450000,China)

机构地区：[1]郸城县妇幼保健院妇产科,河南周口477150 [2]郑州市妇幼保健院产科,河南郑州450000

出　　处：《四川生理科学杂志》2023年第2期231-234,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:对比子宫下段横向环形缝合压迫止血与宫腔纱垫压迫止血在剖宫产宫缩乏力性产后出血患者中的应用效果。方法:回顾性收集2020年1月至2021年9月期间我院收治的剖宫产宫缩乏力性产后出血患者94例作为研究对象,依据治疗方案不同分成研究组与对照组,每组47例。研究组行子宫下段横向环形缝合压迫止血,对照组行宫腔纱垫压迫止血,对比两组术后并发症、手术指标(术后住院时长、手术时长、转ICU率、盆腔血管结扎率)、止血效果(术中出血量、术后2 h出血量、输血率、术后24 h出血量)、子宫恢复状况,包括月经复潮时间、恶露排净时间;并于术后1 m、2 m、3 m采用免疫化学发光法测定黄体生成素(Luteinizing hormone,LH)、卵泡刺激素(Follicule-stimulating hormone,FSH)、雌二醇(Estradiol,E2)水平。结果:研究组术后住院时长短于对照组,转ICU率、盆腔血管结扎率均低于对照组(P<0.05);研究组术中、术后2 h、术后24 h出血量少于对照组,输血率低于对照组(P<0.05);两组术后并发症发生率、月经复潮时间、恶露排净时间、手术时长以及术后1 m、2 m、3 m血清E2、FSH、LH水平对比,无明显差异(P>0.05)。结论:子宫下段横向环形缝合压迫止血用在剖宫产宫缩乏力性产后出血者中,可改善手术效果,快速止血,未产生明显术后并发症,有效保护卵巢功能。Objective:To compare the effect of transverse circular suture hemostasis and uterine gauze pad hemostasis in patients with postpartum hemorrhage caused by uterine atony after cesarean section.Methods:Ninety-four cases of postpartum hemorrhage due to uterine atony during cesarean section admitted to our hospital from January 2020 to September 2021 were retrospectively collected as the study objects.They were divided into a study group and a control group according to different treatment schemes,with 47 cases in each group.The patients in the study group received transverse circular sutures of the lower segment of the uterus to stop bleeding,while the patients in the control group received uterine gauze pads to stop bleeding.The postoperative complications,surgical indicators(length of hospital stay,length of operation,rate of ICU transfer,pelvic vascular ligation rate),hemostatic effects(amount of bleeding during the operation,amount of bleeding 2 hours after the operation,blood transfusion rate,amount of bleeding 24 hours after the operation),uterine recovery status,including the time of rehydration and the time of lochia excretion,were compared.The levels of luteinizing hormone(LH),follicle-stimulating hormone(FSH),and estradiol(E2)were measured by immunochemiluminescence at 1 m,2 m,and 3 m after the operation.Results:The length of hospital stay in the study group was longer than that in the control group,and the rate of ICU transfer and pelvic vascular ligation was significantly lower than in the control group(P<0.05).The amount of bleeding during the operation,2 hours after the operation,and 24 hours after the operation in the study group was less than that in the control group,and the blood transfusion rate was 8.51%lower than that in the control group(25.53%,P<0.05).There was no significant difference in the incidence of postoperative complications,the time of menstruation recovery,the time of lochia excretion,the length of operation,and the level of serum E2,FSH,LH 1 m,2 m,and 3 m after the operation betwee

关 键 词：子宫下段横向环形缝合压迫止血 宫腔纱垫压迫止血 剖宫产 产后出血 性激素 

分 类 号：R71[医药卫生—妇产科学]