前置胎盘剖宫产术中止血带的应用体会

目的探讨止血带在前置胎盘剖宫产术中大出血的止血效果。方法回顾性分析2006年1月～2012年5月在韶山市人民医院妇产科因前置胎盘行剖宫产术的产后出血患者60例,随机分为两组。实验组采用止血带止血后行相应处理,对照组行常规处理,评价止血带的应用效果。结果 60例患者均抢救成功,实验组患者经止血带绑扎暂时止血后行相应处理抢救成功,对照组3例行相应处理后仍有大量出血,行子宫切除术。两组患者在术中出血量、术后24h出血量、止血时间、子宫切除率、术中输血等术中情况比较,差异有统计学意义(P<0.05)。术后贫血、产褥感染率、腹部切口感染率等术后情况比较,差异有统计学意义(P<0.05)。结论止血带法是一种安全、有效、经济的治疗前置胎盘剖宫产术中大出血的方法,值得临床推广应用。

Objective To evaluate the effects of tourniquet in cesarean section for placenta previa. Methods From January 2006 to May 2012,60 pregnant women of placenta previa which placenta was located in anterior wall of uterus in our hospital were enrolled in this study.All of them were divided into two groups as observation group and control group, each group contains 30 patients.The patients in the control group underwent historical methods with low transverse incision while the patients in the observation group using tourniquet to ligate lower uterine segment before incision the uterus. Results 60 patients were successfully salvaged,as all 30 patients in observation group were successfully in controlling of intraoperative bleeding with tourniquet technique.There were 3 patients failed in the control group and had hysterectomy.The amount of blood loss during operation and post-operation, incidence of postpartum hemorrhage, the rate of hysterectomy and the rate of complications in the observation group were significantly lower than those in the control group（P0.05）. Conclusion The using of tourniquet in cesarean section for anterior placenta previa before incision of uterus apparently reduce operative blood loss,it is a safe and effective procedure for treatment of intractable hemorrhage with placenta previa.