经阴道宫颈缝合治疗经阴道分娩的难治性产后出血

Cervical suturing technique for management of intractable postpartum haemorrhage originating from cervical canal

目的评估经阴道宫颈缝合术处理源于宫颈管的难治性产后出血的有效性和安全性。方法25例经阴道分娩的产后出血患者,无软产道损伤,经常规处理无效后经阴道行宫颈缝合术,用2/0可吸收线在宫颈前后唇近穹隆处间断缝合,该手术因阻断了子宫动脉下行支而发挥止血作用。结果所有患者均成功止血,无1例子宫切除术,无并发症发生,抢救成功率100%。该手术无需专门技术和特殊设备。结论经阴道宫颈缝合术处理源于宫颈管的产后出血是一项易操作、安全和高效的保守性手术技术,可避免部分子宫切除术。

Objective To evaluate the efficacy and safety of a novel cervical suturing technique for management of uncontrollable postpartum haemorrhage originating from the cervical canal. Methods Cervical suturing was performed on 25 women, no laceration of soft tissue of genital tract, to control intractable postpartum haemorrhage originating from the cervical canal and not responding to classic management. 2/0 absorbable suture is a new surgical technique which approximates anterior and posterior cervical lips. It controls cervical haemorrhage by obstruction of the descending branch of uterine artery. Results The procedure was effective in all cases and hysterectomy was not needed in any case. No complication occurred and the survival rate was 100%. The procedure required no special expertise or extraordinary equipment. Conclusion Cervical suturing technique for management of postpartum haemorrhage originating from the cervical canal is an easy,safe and highly effective conservative surgical technique that may be alternative to hysterectomy.