宫颈捆扎联合多重正方形缝合治疗剖宫产产后出血的研究

The study of cervical binding combined with hemostatic multiple square suturing technique in treatment of postpartum hemorrhage after cesarean section

目的探讨宫颈捆扎联合多重正方形缝合在治疗剖宫产产后出血的效果。方法将2008—2013年在永川区中医院妇产科采用宫颈捆扎联合多重正方形缝合术治疗剖宫产产后出血的35例患者作为研究组，2008年前后采用传统方法如“8”字缝合术、结扎双侧子宫动脉、子宫填塞纱条等治疗剖宫产产后出血的35例患者作为对照组；观察两组患者产后出血量、手术时间、子宫切除率、产褥病率和子宫复旧情况。结果研究组的手术时间、术后出血量以及产褥病发病率[分别为（52±5）min、（469±12）mL、5．7％]均优于对照组[分别为（71±6）min、（756±10）mL、22．9％]（P〈0．05）。子宫切除率、子宫复旧正常率两组比较差异无统计学意义（P〉0．05）。结论宫颈捆扎联合多重正方形缝合术具有操作简单，止血迅速，安全有效，能保留子宫等优点，在治疗剖宫产产后出血方面效果显著。

Objective To discuss the effect of cervical binding combined with hemostatic multiple square suturing technique in the treatment of postpartum hemorrhage after cesarean section. Methods Clinical data of 35 patients with postpartum hemorrhage after cesarean section underwent cervical binding combined with hemostatic muhiple square suturing technique in TCM Hospital of Yongchuan District during 2008 to 2013 were selected as study group. Another 35 patients underwent traditional methods like ＂8＂ suturing thchnique, bilateral uterine artery ligation and uterine filling yarn around 2008 were selected as control group. The amount of postpartum bleeding, operation time, uterus resection rate, puerperal morbidity, recovery of the womb were compared between two groups. Results The operation time, amount of postpartum bleeding, puerperal morbidity of study group [ （52 ＋ 5 ） min, （469 ＋ 12） mL, 5.7 % respectively ] were better than those of control group the control group [ （71 ＋ 6 ） min, （756 ＋ 10 ） mL, 22. 9 % respectively ] （ P 〈 0. 05 ）. There were no statistically significant differences in puerperal morbidity, ratio of recovery of the womb （ P 〉 0. 05 ）. Conclusion As a newly developed surgical method, cervical strapping combined with multiple square suturing is simple,quick, safe and effective, which can retain the uterus and has a remarkable effect in the treatment of postpartum hemorrhage after cesarean section.