双侧子宫动脉结扎术联合水囊压迫治疗前置胎盘剖宫产出血的疗效  

Therapeutic effect of bilateral uterine artery ligation combined with water sac compression in the treatment of cesarean section hemorrhage of placenta previa

作　　者：张金凤 林李珍 阮琴 ZHANG Jinfeng;LIN Lizhen;RUAN Qin(Department of Obstetrics and Gynecology,Zhangzhou Zhengxing Hospital,Zhangzhou,Fujian,363000,China)

机构地区：[1]漳州正兴医院妇产科,福建漳州363000

出　　处：《当代医学》2023年第1期121-123,共3页Contemporary Medicine

摘　　要：目的探讨双侧子宫动脉结扎术联合水囊压迫治疗前置胎盘剖宫产出血的临床疗效。方法选取2019年5月至2020年7月本院收治的130例前置胎盘剖宫产出血产妇作为研究对象,随机分为观察组与对照组,各65例。对照组采取宫腔纱布填塞止血法,观察组采取双侧子宫动脉结扎联合水囊压迫术止血法,比较两组手术情况、手术结局、子宫与卵巢恢复情况。结果观察组手术时间短于对照组,术中出血量少于对照组,输血率低于对照组,差异有统计学意义(P<0.05)。观察组术后24h白细胞计数、术后24h出血量均少于对照组,术后24h发热率、子宫切除率均低于对照组,差异有统计学意义(P<0.05);两组子宫恢复不良率比较差异无统计学意义。两组宫腔粘连率、月经减少率、雌二醇水平、卵泡刺激素水平及黄体生成素水平比较差异无统计学意义。结论双侧子宫动脉结扎术联合水囊压迫止血法治疗前置胎盘剖宫产出血效果显著,能明显缩短手术时间,减少出血量,降低子宫切除率及术后发热率,且不影响产妇术后恢复,值得临床推广应用。Objective To investigate the clinical effect of bilateral uterine artery ligation combined with water sac compression in the treatment of cesarean section hemorrhage of placenta previa.Methods A total of 130 parturients with cesarean section hemorrhage of placenta previa admitted to our hospital from May 2019 to July 2020 were selected as the research subjects,and they were randomly divided into observation group and control group,with 65 cases in each group.The control group was treated with intrauterine gauze packing hemostasis,and the observation group was treated with bilateral uterine artery ligation combined with water sac compression hemostasis,the surgical conditions,surgical outcomes,uterine and ovarian recovery were compared between the two groups.Results The operation time in the observation group was shorter than that of the control group,the intraoperative blood loss was less than that in the control group,and the blood transfusion rate was lower than that in the control group,the differences were statistically significant(P<0.05).The white blood cell count and bleeding volume at 24 h after operation in the observation group were less than those in the control group,and the fever rate and hysterectomy rate at 24 h after operation were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the rate of poor uterine recovery between the two groups.There was no significant difference in intrauterine adhesion rate,menstrual reduction rate,estradiol level,follicle stimulating hormone level and luteinizing hormone level between the two groups.Conclusion Bilateral uterine artery ligation combined with water sac compression hemostasis is effective in the treatment of cesarean section hemorrhage of placenta previa,it can significantly shorten the operation time,reduce the amount of bleeding,reduce the rate of hysterectomy and postoperative fever,and does not affect the postoperative recovery of parturients,it is worthy of clinical app

关 键 词：子宫动脉结扎术 水囊压迫 前置胎盘 剖宫产 出血 

分 类 号：R719.8[医药卫生—妇产科学]