子宫体双侧弓形动脉缝扎术用于剖宫产子宫收缩乏力性出血临床研究

Bilateral uterine actuate artery ligation for cesarean section uterine agony hemorrhage

目的观察子宫体双侧弓形动脉缝扎术(简称止血术)用于剖宫产术中子宫收缩乏力性出血的临床效果。方法取广元市中心医院2010年3月至2013年1月收治的剖宫产术中子宫收缩乏力性出血患者120例,设为实验组,通过子宫体双侧弓形动脉缝扎术止血;另取同期收治的采用常规止血方式的患者120例设为对照组。对比两组患者的即刻止血率、止血有效率和总有效率等,术后通过阴道彩超测定患者子宫血循环指标子宫动脉阻抗指数(RI)和收缩期峰值与舒张末期血流速度(S/D)比值。结果实验组患者的术中出血量、手术耗时和产褥病发生率均较对照组更低,实验组患者的即刻止血率和总有效率均较对照组更高,差异均具统计学意义(P<0.05);两组患者术后子宫血循环指标RI和S/D比值比较差异无统计学意义(P<0.05)。结论剖宫产术中子宫收缩乏力性出血采用止血术能有效减少患者术中出血和手术耗时,止血效果显著且并发症发生率更低。

Objective To observe and explore bilateral uterine actuate artery ligation （referred to homeostasis） for cesarean section uterine agony bleeding clinical results. Methods Our hospital admissions since 2010 cesarean uterine ag- ony bleeding 120 patients ,the patient through bilateral actuate uterus to stop the bleeding artery ligation, for the experi- mental group; another year in our hospital receiving conventional haemostatic methods 120 patients for the control group. statistics and calculate the rate of the two groups of patients with immediate bleeding, bleeding efficient, effective and to- tal efficiency, postoperative patients through the vaginal ultrasound measurement uterine blood circulation indicators uter- ine artery resistance index （RI） and peak systolic and diastolic velocity （S/D） ratio were compared. Results The pa- tient~ blood loss, operation time and puerperal disease incidence rate lower than the control group, the experimental group of patients with immediate homeostasis rate and total effective rate higher than those of the control group, the differences were statistically significance （ P 〈 0. 05 ） ; postoperative uterine blood circulation index RI and S / D ratio comparing the difference was not statistically significant （ P 〈 0. 05 ）. Conclusion Cesarean section uterine agony bleeding using ho- meostasis in patients with bleeding and can effectively reduce the operation time, bleeding effect is significant and the complication rate is lower.