宫腔纱条填塞术在控制剖宫产难治性出血中的应用

Uterine Gauze Cesarean Surgery in the Control Intractable Hemorrhage

目的探讨剖宫产术中宫腔纱条填塞术在控制难治性出血的应用效果。方法选取2011年1月—2013年1月在该院产科剖宫产手术中子宫出血〉1 000 m L的产妇64例,其中36例宫腔纱条填塞止血,采用甲硝唑液浸湿挤干的高温消毒纱条一根长5 m,宽8 cm,厚5层,有序均匀压紧填充宫腔不留死腔。结果最短术后20 h、最长术后40 h取出纱条,平均放置（24.3±3.5）h,纱条取出无困难。取出的纱条全部血染22例,纱条部分血染14例,1例术后病率及时取出纱条加强抗感染治疗好转,36例术后6周随访子宫复旧良好,其中15例未失访者于4~11月月经复潮。结论宫腔纱条填塞术控制剖宫产难治性出血临床应用效果显著,患者术后恢复良好,值得在基层产科临床中广泛推广应用。

Objective To investigate the uterine cesarean section surgery in the application of gauze effect control intractable bleeding. Methods January 20l 1 - January 2013, 5 197 cases of cesarean section in our hospital obstetrics, bleeding 〉1000 ml 64 cases, including 36 cases of uterine hemostatic gauze, using metronidazole squeezed the pasteurized liquid soaked gauze a length of 5 m, width 8 cm, 5 layers thick, orderly pressed uniformly filling the uterine cavity do not stay dead. Results The shortest post- operative 20 hours, the longest gauze removed after 40 hours, an average of （24.3＋3.5）hours to place sliver removed without diffi- culty. All bloody gauze removed in 22 cases, 14 cases of bloody gauze part, one case of postoperative morbidity promptly removed gauze strengthen anti-infection treatment improved, 36 cases of uterine involution after 6 weeks of follow-up well, including 15 cases without conceding respondents in the April-November menstruation. Conclusion The surgical gauze control cesarean uterine bleeding refractory significant clinical effect, worthy of clinical obstetrics at the grassroots widely applied.