子宫下段环扎术治疗凶险性前置胎盘剖宫产术后出血的效果

Effects of lower uterine segment cerclage in treatment of postoperative hemorrhage after cesarean of pernicious placenta previa

目的探讨子宫下段环扎术治疗凶险性前置胎盘剖宫产术后出血的临床效果。方法选择我院2011年1月~2014年1月收治的54例凶险性前置胎盘剖宫产后出血患者,患者分为观察组和对照组各27例。观察组采用子宫下段剖宫产术止血,对照组采用宫腔纱布填塞止血。比较两组治疗效果。结果干预前观察组和对照组出血量、缩宫素用量差异均无统计学意义（P〉0.05）。观察组卡前列素氨丁三醇注射液的用量、干预时出血量、干预后出血量、术中总出血量、干预时间、总输血量均低于对照组,差异均有统计学意义（P〈0.05）。观察组的止血成功率为96.30%,对照组为92.59%,差异无统计学意义（P〉0.05）。两组均未发生子宫坏死、感染、宫腔积血等并发症。结论子宫下段环扎术治疗凶险性前置胎盘剖宫产术后出血,止血迅速,出血量少,可减少产后出血发生率,值得临床推广。

Objective To study the clinical effects of lower uterine segment cerclage in treatment of postoperative hem- orrhage after cesarean of pernicious placenta previa. Methods 54 cases of patients with postoperative hemorrhage after cesarean of pernicious placenta previa admitted in our hospital from January 2011 to January 2014 were selected and divided into the observation group （n=27） and the control group （n=27）.The observation group was given lower uterine segment cerclage for postoperative hemorrhage while the control group was adopted uterine gauze packing.The treatment effect was compared in two groups. Results There were no statistically significant differences between the two groups in the amount of blood loss before intervention and the dosage of oxytocin （P 〉0.05）.The amount of Carboprost Tromethamine Injection used in the intervention group was obviously lower than that of the control group.And the amount of blood loss during and after intervention,the total amount of intraoperative blood loss,intervention time and the total amount of blood transfusions in the intervention group were all statistically significantly lower than those of the control group （P〈0.05）.The success rate of hemostasis was 96.30% in the observation group while 92.59% in the control group （P〉0.05）.No complications such as uterine necrosis,infection or hematometra were found in any group. Conclusion Lower uterine segment cerclage Can treat postoperative hemorrhage cesarean of pernicious placenta previa,which can stop bleeding rapidly,reduce blood loss and reduce the incidence of postpartum hemorrhage,worthy of promotion.