宫颈环扎术加球囊填塞法在产后出血中的应用

The Application of cervical cerclage combined with intrauterine balloon tamponade in the treatment of postpartum hemorrhage

目的评价宫颈环扎术加球囊填塞法治疗产妇产后出血的效果。方法选取2008-2013年重庆永川区中医院73例产后出血患者资料,根据不同的止血方法分为观察组38例,对照组35例。观察组采用宫颈环扎术加球囊填塞法治疗产后出血,对照组采用传统方法如＂8＂字缝合术、结扎双侧子宫动脉、子宫填塞纱条等治疗产后出血。比较两组止血成功率、手术时间、术后出血量等指标。结果两组止血成功率（分别为100%、97.1%）,比较差异无统计学意义（P〉0.05）;手术时间（分别为10.3 min、34.5 min）、术后出血量（分别为496.2 m L、872.3 m L）、术后产褥病率（分别为5.3%、25.7%）、术后下床活动时间（分别为23.1h、60.5 h）、住院时间（分别为6.8 d、13.9 d）等方面比较,观察组皆优于对照组（P〈0.05）。结论宫颈环扎术加球囊填塞法具有操作简单,止血迅速,安全有效,能保留子宫等优点,治疗剖宫产产后出血效果显著。

Objective To discuss the effect of the cervical cerclage combined with intrauterine balloon tamponade in the treatment of postpartum hemorrhage. Methods Data of 73 cases with postpartum hemorrhage in TCM Hospital of Yongchuan District during 2008 to 2013 were selected. All cases were divided into observation group（ n = 38 ） and control group（ n = 35 ）. The observation group adopted the cervical cerclage combined with intrauterine balloon tamponade, and the control group took traditional methods like ＂8＂ suturing technique, bilateral artery ligation and gauze packing as treatment for postpartum hemorrhage. The effect indicators such as hemostatic rate, operation time, postoperative blood loss, et al were compared between two groups. Results There was no statistical difference between two groups in the hemostatic rate （ 100 % and 97. 1% respectively） （P 〉 0. 05）. The observation group were better than the control group in operation time （ 10. 3 rain and 34. 5 min respectively）, postoperative blood loss（496. 2 mL and 872. 3 mL respectively） , morbidity of puerperalism（5.3 % and 25.7 % respectively） , postoperative ambulation time （23.1 h and 60. 5 h respectively） and length of hospital stay （6. 8 d and 13.9 d respectively） （ P 〈 0. 05 ）. Conclusion The cervical cerclage combined with intrauterine balloon tamponade is simple, quick, safe and effective and conservative treatment for postpartum hemorrhage.