子宫动脉上行支结扎联合产后止血球囊治疗中央性前置胎盘的临床效果  

Clinical Effect of Ascending Branch of Uterine Artery Ligation Combined With Postpartum Hemostatic Balloon in the Treatment of Central Placenta Previa

作　　者：罗丹青 刘宗玉 念雅玲 LUO Danqing;LIU Zongyu;NIAN Yaling(Department of Obstetrics,Mindong Hospital of Ningde City,Ningde Fujian 355000,China)

机构地区：[1]宁德市闽东医院产科,福建宁德355000

出　　处：《中国卫生标准管理》2024年第8期30-34,共5页China Health Standard Management

摘　　要：目的探讨剖宫产术中采用双侧子宫动脉上行支结扎术联合宫腔填塞产后止血球囊对中央性前置胎盘所致产后出血的临床效果和影响。方法选择宁德市闽东医院2020年1月—2022年12月收治的80例中央性前置胎盘所致产后出血患者为研究对象。按治疗方式不同分为观察组(40例)和对照组(40例);对照组在剖宫产术中联合使用子宫压迫缝合及宫腔填塞纱布条传统止血技术;观察组采用双侧子宫动脉上行支结扎术联合宫腔填塞产后止血球囊的联合止血技术。比较2组治疗效果。结果观察组的止血时间、24 h出血量、术中出血量、手术时间及输血率均优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组的血红蛋白水平为(98.82±3.24)g/L、血细胞比容为(32.57±2.08)%,高于对照组的(95.65±2.77)g/L、(25.65±1.58)%,差异有统计学意义(P<0.05)。2组产褥感染率、子宫切除率、子宫动脉栓塞发生率及入住ICU率比较,差异无统计学意义(P>0.05)。治疗后,观察组的凝血酶时间(thrombin time,TT)长于对照组,凝血酶原时间(prothrombin time,PT)、D-二聚体(D-Dimer,D-D)、纤维蛋白原(fibrinogen,FIB)水平均低于对照组,差异有统计学意义(P<0.05)。结论采用双侧子宫动脉上行支结扎术联合宫腔填塞产后止血球囊的联合止血技术对中央性前置胎盘所致产后出血的临床治疗效果显著,能缩短手术时间,减少出血量,且与传统治疗方案相比并不会增加产褥感染率、子宫切除率的风险。此文的研究结果为中央性前置胎盘治疗方案的后期标准制定提供了借鉴内容。Objective To explore the clinical effect and impact of bilateral uterine artery ascending branch ligation combined with uterine cavity packing with postpartum hemostatic balloon during cesarean section on postpartum hemorrhage caused by central placenta previa.Methods A tota of 80 patients with postpartum hemorrhage caused by central placenta previa admitted to Mindong Hospital of Ningde City from January 2020 to December 2022 were selected as the research subjects.They were divided into an observation group(40 cases)and a control group(40 cases)according to treatment methods.The control group used traditional hemostatic techniques such as uterine compression suture and uterine cavity filling gauze during cesarean section.The observation group used a combined hemostatic technique of bilateral uterine artery ascending branch ligation and uterine cavity packing with Bakri balloons.The treatment effects were compared between the two groups.Results The observation group's haemostasis time,24 h haemorrhage,intraoperative haemorrhage,operation time and blood transfusion rate were better than those of the control group,the differences were statistically significant(P<0.05).After treatment,The hemoglobin level and erythrocyte pressure volume of the observation group were(98.82±3.24)g/L and(32.57±2.08)%,which were higher than those of the control group(95.65±2.77)g/L and(25.65±1.58)%,the differences were statistically significant(P<0.05).In terms of puerperal infection rate,hysterectomy rate,incidence of uterine artery embolism and ICU admission rate,there was no significant difference between the two groups(P>0.05).After treatment,the thrombin time(TT)level of the observation group was higher than that of the control group,and the levels of prothrombin time(PT),D-dimer(D-D)and fibrinogen(FIB)were lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion The combined hemostatic technique of bilateral uterine artery ascending branch ligation combined with uterine cavity packin

关 键 词：产后止血球囊填塞术 子宫动脉结扎 中央性前置胎盘 产后出血 剖宫产 凝血功能 

分 类 号：R714[医药卫生—妇产科学]