止血带止血法在高危型剖宫产术中的应用

Hemostasis With Tourniquet in High Risk Caesarean Section

目的探讨止血带止血法在高危型剖宫产术中应用的效果和可行性。方法采用回顾性分析36例剖宫产术中因前置胎盘(21例)、胎盘植入(7例)、子宫肌瘤(13例)等原因导致的子宫异常出血的患者作为实验组,采用止血带直接捆绑子宫下段,暂时完全阻断子宫血供,以达到止血或减少出血的目的。选择同期未用止血带的剖宫产术中行子宫肌瘤剥除术15例为对照组,对两组合并子宫肌瘤者术中、术后出血量和止血时间进行比较。结果实验组36例子宫异常出血患者取得良好效果。其中仅3例因凶险性前置胎盘合并胎盘植入行子宫次全切除术,其余33例均成功保住了子宫,术中出血明显减少。两组合并子宫肌瘤者术中出血量和止血时间比较,差异均有显著性。结论止血带捆绑子宫下段阻断子宫血流操作简单,止血迅速、安全可靠,是一种行之有效的方法。

Objective To assess the effect and feasibility of hemostasis with tourniquet during high risk caesarean section. Methods Retrospectively analyze 36 parturients abnormal bleeding during caesarean section with placenta pre- via, placenta implant, hysteromyoma . In order to stop or diminish bleeding, they were performed binding at lower uterine segment with tourniquet, to block uterine blood flow temporarily. Select 15 instances with hysteromyoma divested during caesarean section without tourniquet as control group. We compare the bleeding and haemostasis time in the two groups with hysteromyoma. Results All of 36 abnormal bleeding parturients had good effect with this method, only 3 of them were performed subtotal hysterectomy because of dangerous placenta previa complicated with placenta implant, others kept their uterine successfully, and hemorrhage was decreased obviously during caesarean section. Parturients with hysteromyoma in two groups have significant difference in bleeding and haemostasis time. Conclusion The method of hemostasis with tourniquet is simple,quickly,effective and safe in blocking uterine blood during caesarean section .