宫颈提拉式缝合治疗特殊剖宫产术中宫颈管顽固性出血的临床疗效  

Clinical efficacy of cervical traction suture in the treatment of intractable cervical bleeding during special cesarean section

作　　者：吴琦 黎娇 时慧 陈静 彭淋 刘建 WU Qi;LI Jiao;SHI Hui;CHEN Jing;PENG Lin;LIU Jian(Department of Obstetrics,Southeast Hospital of Chongqing,Chongqing,401336,China;Department of Gynecology,Southeast Hospital of Chongqing,Chongqing,401336,China)

机构地区：[1]重庆市东南医院产科,重庆401336 [2]重庆市东南医院妇科,重庆401336

出　　处：《当代医学》2023年第21期94-97,共4页Contemporary Medicine

摘　　要：目的探讨宫颈提拉式缝合治疗特殊剖宫产术中宫颈管顽固性出血的临床疗效。方法选取2018年2月至2022年10月本院收治的46例特殊剖宫产术中宫颈管顽固性出血产妇作为研究对象,按照止血方法不同分为观察组与对照组,每组23例。观察组予以宫颈提拉式缝合止血治疗,对照组予以宫腔填塞术治疗,比较两组围手术期指标、子宫底高度、围手术期并发症发生率、产后42 d子宫大小及宫颈长度。结果观察组手术时间、止血时间均短于对照组,术中出血量、输血量、术后24 h阴道出血量均少于对照组,差异有统计学意义(P<0.05)。产前,两组子宫底高度比较差异无统计学意义;术后3 d,两组子宫底高度均低于产前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组围手术期并发症发生率为8.69%,低于对照组的34.78%,差异有统计学意义(P<0.05)。产后42 d,两组子宫大小及宫颈长度比较差异无统计学意义。结论宫颈提拉式缝合治疗特殊剖宫产术后宫颈管顽固性出血效果显著,有效缩短手术时间、止血时间,减少手术出血量及围手术期并发症的发生,促进子宫恢复,且不影响子宫宫颈解剖结构恢复,安全性较高,值得临床推广应用。Objective To investigate the clinical efficacy of cervical traction suture in the treatment of intractable cervical bleeding after special cesarean section.Methods 46 parturients with intractable cervical bleeding during special cesarean section admitted to our hospital from February 2018 to October 2022 were selected as the study subjects,and they were divided into the observation group and the control group according to different hemostasis methods,with 23 cases in each group.The observation group received cervical traction suture for bleeding treatment,the control group received intrauterine packing surgery,the perioperative indicators,uterine fundal height,incidence of perioperative complications,and uterine size and cervical length at 42 d postpartum were compared between the two groups.Results The operation time and hemostasis time in the observation group were shorter than the control group,the intraoperative bleeding,transfusion volume,and 24 h postoperative vaginal bleeding volume were less than the control group,and the differences were statistically significant(P<0.05).Before childbirth,there was no significant difference in uterine fundal height between the two groups;at 3 d postoperatively,the uterine fundal height of the two groups was lower than before childbirth,and the observation group was lower than control group,and the differences were statistically significant(P<0.05).The incidence of perioperative complications in the observation group was 8.69%,which was lower than 34.78%in the control group,and the difference was statistically significant(P<0.05).At 42 d postpartum,there were no significant differences in uterine size and cervical length between the two groups.Conclusion The effect of cervical traction suture in the treatment of intractable cervical bleeding after special cesarean section is significant,which can effectively shorten the operation time,hemostasis time,reduce intraoperative bleeding and the occurrence of perioperative complications,and promote uterine recovery,and does not

关 键 词：宫颈管顽固性出血 宫颈提拉式缝合 特殊剖宫产术 宫腔填塞术 

分 类 号：R719.8[医药卫生—妇产科学]