子宫背包式缝合术在剖宫产术中子宫收缩乏力性出血中的应用

Application of Uterine Backpack Suture for Hemorrhage Caused By Uterine Contractions Atony in Cesarean Section

目的探讨子宫背包式缝合术在剖宫产术中子宫收缩乏力性出血中的应用及临床效果。方法回顾性分析我院2009年3月至2012年5月收治的62子宫收缩乏力性产后出血患者,其中采用子宫背包式缝合术31例患者作为观察组,采用宫腔填塞治疗的31例为对照组。比较两组患者治疗总有效率、平均手术时间及术中平均出血量。结果观察组治疗总有效率为96.4%,对照组为83.2%,两组比较差异具有统计学意义,P<0.05;观察组平均手术时间及术中平均出血量均少于对照组,两组比较有明显差异,P<0.01;观察组无1例实行子宫切除术,对照组3例行子宫切除术,两组比较无明显差异,P>0.05。结论子宫背包式缝合术对于子宫的压迫更加完全,使得止血更加迅速,且操作简便,安全性高,可保留器官完整,保全生育功能,值得推广。

Objective To investigate the clinical effect of uterine backpack suture for hemorrhage caused by uterine contractions atony in cesarean section. Methods 62 patients with postpartum hemorrhage caused by uterine contractions atony in our hospital from March 2009 to May 2012 were analyzed retrospectively. 31 patients with uterine backpack suture were set as observation group, and 31patients with intrauterine packing were set as control group. The effective rate, average operative time, and intraoperative blood loss amount were compared between the two groups. Results The total effective rate of the observation group was 96.4%, significantly higher than83.2% of the control group（P 0.05）. The average operative time and intraoperative blood loss amount of the observation group were significantly less than those of the control group（P 0.01）. No case received hysterectomy in the observation group and and 3 cases received hysterectomy in the control group, with no statistical difference（P 0.05）. Conclusions Uterine backpack suture has more complete pressing for uterus, allows quicker hemostasis with easy operation and high safety to retain complete organs and preserve fertility, which is worthy of clinical application.