剖宫产术中缝合子宫浆肌层治疗产后出血16例临床观察

Clinical observation of uterine serosa and myometrium suturing in intractable post-partum hemorrhage during cesarean section

目的评价剖宫产术中缝合子宫浆肌层治疗难治性产后出血的有效性和安全性。方法对41例产后出血进行回顾性分析,16例剖宫产术中采用常规方法止血无效的患者进行子宫浆膜层和肌层缝合。结果16例剖宫产术中出血患者经采用缩宫药物、按压子宫、宫腔局部缝合及子宫动脉结扎均无效后,采用子宫浆膜层和肌层缝合后全部止血成功,其中3例加宫腔纱条填塞,无并发症发生,全部保留子宫。结论子宫浆膜层和肌层缝合技术处理剖宫产术中难治性产后出血简单、有效、安全,是避免子宫切除的一项高效保守性手术。

Objective To evaluate the efficacy and safety of uterine serosa and myometrium suturing technique for management of intractable post-partum hemorrhage （PPH） during cesarean section. Methods Retrospective analysis of 41 cases with PPH, uterine serosa and myometrium suturing was performed on 16 cases to control intractable PPH during cesarean section and not responding to routine management. Results Sixteen cases of intractable PPH during cesarean section, which was not controlled by oxytocin drugs, manual compression of the uterus, local suturing on uterine cavity, uterine artery ligation, were performed with uterine serosa and myometrium suturing, Utering packing was performed on 3 cases. Conclusion Uterine serosa and myometrium suturing for management of intractable PPH during cesarean section is an easy, safe and highly effective conservative surgical technique that may be alternative to hysterectomy.