基层医院预防剖宫产产后出血应用子宫动脉上行支结扎术的疗效分析  

Analysis of the Therapeutic Effect of Uterine Artery Ascending Branch Ligation in Preventing Postpartum Hemorrhage after Cesarean Section in Primary Hospitals

作　　者：张珺 徐惠娟 李清花 颜小红 Zhang Jun(Obstetrics and Gynecology Department of Shouning County Hospital,Fujian Province,Shouning Fujian 355500)

机构地区：[1]福建省寿宁县医院妇产科,福建寿宁355500 [2]福建省宁德市闽东医院产科,福建宁德355000

出　　处：《黑龙江医药》2024年第6期1278-1281,共4页Heilongjiang Medicine journal

基　　金：宁德市自然科学基金联合项目(编号:2022J64)。

摘　　要：目的:探讨基层医院预防剖宫产产后出血应用子宫动脉上行支结扎术的疗效。方法:选择宁德市寿宁县医院2022年11月—2024年2月收治的80例剖宫产术中出血、有产后出血高危因素患者研究,根据预防性干预措施不同分组,分别为卡贝缩宫素组(对照组,n=40)、子宫动脉上行支结扎术组(研究组,n=40),比较效果。结果:两组手术时间、住院时间比较无差异(P>0.05);两组术前血红蛋白、红细胞压积比较无差异(P>0.05),术后24h研究组血红蛋白、红细胞压积明显更高(P<0.05);与对照组比较,术中出血量、术后2h出血量、术后24h出血量研究组均更低(P<0.05);与对照组比较,研究组术后第一次月经恢复时间更短(P<0.05);与对照组比较,研究组术后子宫复旧良好率更高(P<0.05)。结论:相比卡贝缩宫素预防性用于基层医院剖宫产产后出血中,予以子宫动脉上行支结扎术可更好地减少术中及术后出血,改善血红蛋白、红细胞压积,同时还可以缩短术后第一次月经恢复时间,有助于术后子宫更好地复旧,有应用价值。Objective:To explore the efficacy of uterine artery ascending branch ligation in preventing postpartum hemorrhage after cesarean section in grassroots hospitals.Methods:A total of 80 patients who underwent cesarean section with intraoperative bleeding and had risk factors for postpartum hemorrhage,treated at Shouning Hospital in Ningde City from November 2022 to February 2024,were selected for the study.Based on different preventive intervention measures,the patients were divided into two groups:the Carboprost group(control group,n=40)and the uterine artery ascending branch ligation group(study group,n=40),the effects were compared.Results:There were no differences in operative time and length of hospital stay between the two groups(P>0.05).Preoperative hemoglobin and hematocrit levels were also comparable between the two groups(P>0.05).However,at 24 hours postoperatively,the hemoglobin and hematocrit levels in the study group were significantly higher(P<0.05).Compared to the control group,the intraoperative blood loss,as well as the blood loss at 2 hours and 24 hours postoperatively,were all lower in the study group(P<0.05).Additionally,the time to the first menstrual recovery after surgery was shorter in the study group compared to the control group(P<0.05).Furthermore,the rate of good uterine involution in the study group was higher than that in the control group(P<0.05).Conclusion:Compared to the prophylactic use of Carbetocin for preventing postpartum hemorrhage in cesarean sections in grassroots hospitals,uterine artery ascending branch ligation can more effectively reduce intraoperative and postoperative bleeding,improve hemoglobin and hematocrit levels,and shorten the time to the first menstrual recovery after surgery,thereby facilitating better uterine involution postoperatively.This procedure has significant clinical value.

关 键 词：剖宫产 产后出血 子宫动脉上行支结扎术 血红蛋白 月经恢复时间 

分 类 号：R719[医药卫生—妇产科学]