简易子宫压迫缝合术在防治剖宫产术中宫缩乏力性出血中的临床应用

Clinical Application of Prevention and Treatment to Contraction Fatigue Hemorrhage in Cesarean Section with a Simple Uterine Compression Suture

目的探讨一种简易子宫压迫缝合术在剖宫产术中防治宫缩乏力性子宫出血的临床作用与疗效。方法选择2012年2月至2013年8月兰州军区乌鲁木齐总医院收治的80例剖宫产术中发生宫缩乏力性子宫出血的患者为研究对象,按入院顺序号随机分为两组,简易子宫压迫缝合术组(n=50)及改良B-Lynch组(n=30),观察比较其止血效果。两组患者年龄等一般临床资料比较,差异无统计学意义(P>0.05)(本研究遵循的程序符合兰州军区乌鲁木齐总医院人体试验委员会制定的伦理学标准,分组得到该委员会批准,征得受试对象知情同意,并与之签署临床研究知情同意书)。结果应用该简易子宫压迫缝合术,50例剖宫产术中宫缩乏力性子宫出血患者均有效止血,患者的产后出血量显著少于接受改良B-Lynch组患者,且差异有统计学意义(t′=4.309 1,P<0.05);止血时间亦显著短于改良B-Lynch组,且差异有统计学意义(t′=7.947 9,P<0.05)。简易子宫压迫缝合术组中仅1例患者需输血治疗。两组患者中无一例再次发生产后出血,亦无一例因产后出血导致子宫切除。结论该子宫压迫缝合术操作技术简单、便于掌握,止血安全、有效、迅速,能保留患者子宫和生育能力,容易被患者接受,是一种防治剖宫产术中宫缩乏力性出血的有效止血方法。

Objective To explore effect of clinical application of prevention and treatment to contraction fatigue uterine hemorrhage in cesarean section with a simple uterine compression suture. Methods A total of 80 cases of contraction fatigue haemorrhage in cesarean section from February 2012 to August 2013 in Urumqi General Hospital, Lanzhou Military Area Command were randomly（according to admission sequence number）divided into two groups： the simple uterine compression suture treatment group（n=50）and the modified B-Lynch group（n=30）,then observed their hemostatic effect. The general clinical data（such as age） of two groups had no significant difference （P〉0.05）. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Urumqi General Hospital, Lanzhou Military Area Command.Informed consent was obtained from each participating patient. Results Through applying to the uterine compression suture, 50 cases of contraction fatigue uterine haemorrhage all stopped bleeding effectively in cesarean section, the postpartum hemorrhage was significantly less than modified B-Lynch group （t＇=4.309 1,P〈0.05）; hemostatic time was significantly shorter than modified B-lynch group （t＇=7.947 9, P〈0.05）. Only 1 case needed a blood transfusion in simple uterine compression suture treatment group. All patients didn＇t have postpartum hemorrhage again and uterine resection which caused by postpartum hemorrhage. Conclusions We have found this uterine compression suture is a simple one, which is easy to be grasped by the doctors.Through this technology, stop bleeding is safe, effective and rapid,which is easily accepted by pregnant women for it can retain the uterus and fertility.It is also a kind of effective hemostatic method in prevention and control of contraction fatigue hemorrhage in cesarean section.