宫腔纱布填塞治疗产后出血的方法改进

Improvement of treatment of postpartum hemorrhage by intrauterine packing with gauze

目的探讨治疗产后出血的安全有效方法。方法采用长100 cm、宽4 cm、厚4层的无菌纱条,以生理盐水浸湿、挤干,用卵圆钳夹住纱条一端,从阴道置入子宫腔,自子宫底起来回折叠,将整个子宫腔填紧塞满,不留空隙;剖宫产者在切口处充分估计拟填充子宫下段所需纱条长度,剪去多余纱条,先将尾端放置宫颈口附近,然后将剩余纱条充分填塞子宫下段,直视下缝合子宫切口。结果 16例产后出血患者均取得满意的止血效果,有效率达100%。产后42 d来院随访13例,子宫复旧良好,无产褥期出血及盆腔感染。结论改良的宫腔纱布填塞技术是治疗产后出血的简便、安全、有效的方法。

Objective To study the effective and safe method to treat postpartum hemorrhage by intrauterine packing with gauze.Methods The four layers of gauze with 100cm in length and 8cm in width were wet through with normal saline,and then squeezed the water out.One end of gauze was clipped with oval forceps,and filled in cavity of uterine body from bottom of uterine to pack by means of folding through vagina.To patient with hysterotokotomy,the length of gauze to pack inferior section of uterine from the incision would be fully estimated,cut unnecessary gauze,then put its end near neck of uterus,finally sutured the incision under direct vision.Results 16 patients were treated by this method,all of them achieved in satisfactory result.The effective rate was 100%.13 patients were followed up 42 days later postpartum,a good involution of uterus was showed,and puerperal hemorrhage and pelvic infection didn＇t appear in all cases.Conclusion Advanced intrauterine packing with gauze is an simple、safe and effective method to treat postpartum hemorrhage.