宫颈环扎术及球囊压迫宫腔在难治性产后出血中的应用

Application of cervical cerclage and uterine balloon compression for intractable postpartum hemorrhage

目的探讨宫颈环扎术及球囊压迫宫腔在难治性产后出血中的临床疗效。方法选择2007年2月15日-2009年10月10日收治的难治性产后出血患者56例,所有患者均药物治疗效果不佳,且处于休克状态不能控制出血时,按照止血方式的不同,随机分为观察组和对照组各28例。观察组28例采用宫颈环扎术及球囊压迫宫腔的方法治疗难治性产后出血,对照组28例则行子宫切除术治疗难治性产后出血。并比较两组的手术时间、住院时间、有效率等临床上止血方法的效果。结果观察组28例采用宫颈环扎术及球囊压迫宫腔止血方法治疗的难治性产后出血,止血有效率为100%,术后子宫复旧好,保留了子宫及其生理功能,无严重的并发症发生,对照组28例采用常规性子宫切除术止血的有效率为89.29%。两组止血效果、手术时间、住院时间等比较差异有显著性(P<0.05)。结论宫颈环扎术及球囊压迫宫腔止血法简单易行,止血迅速可靠,效果好,保留了患者子宫和生育功能,有显著的优点及临床的实用价值,可替代子宫切除术,值得在基层医院大力推广。

Objective To investigate the clinical efficacy of the cervical cerclage and uterine balloon compression in intractable postpartum hemorrhage.Methods 56 patients with intractable postpartum hemorrhage were dealled dining the time from February 15,2007 to October 10, 2009.All of them were with ineffective drug therapy,in a state of shock and uncontrolled bleeding,according to the different ways to stop bleeding,they were randomly divided into two groups,and each for 28 cases.The observation gYoup with 28 cases were dcalled with cervical cerclage and uterine balloon compression for the refractory postpartum hemorrhage;and the control group with 28 cases were treated for the hysterectomy.And two groups were compared on the factor： the operative time,hospitalization time,and efficient methods such as clinical hemostatic effect.Results The haemostasis rate of the observation group was 100%,uterine involution is good after operation,retainning the uterus and its physiological function,none of severe complications occurred.In the control group,the haemostasis rate was 89.29%.Haemostatie effects,operative time,hospitalization time,etc of these two group have more statistically significance（P〈0.05）.Conclusions Cervical cerelage and uterine bleeding balloon-compression method are simple to use,hemostasis are fast,reliable and has good effect,it can also retain the uterus and reproductive function,it has significant clinical advantages and practical value,and can replace hysterectomy, it is worth for the basical level hospital to spread.