宫腔尿管联合子宫环形捆绑治疗剖宫产术中产后出血的疗效

Effect of combination therapy of intrauterine catheter combined with uterine ring bundle on postpartum hemorrhage in cesarean section

目的探讨宫腔尿管联合子宫环形捆绑治疗剖宫产术中产后出血的临床疗效。方法选取2012年5月至2015年5月本院收治的剖宫产术中产后出血产妇140例,随机分为对照组和观察组各70例,其中对照组采用宫腔内填塞纱布联合子宫环形捆绑术进行治疗,观察组先采用Foleys双腔导尿管填塞宫腔联合子宫环形捆绑术进行治疗,比较两组产妇术中、术后情况,并观察分析两组产妇生产前后血常规检查结果。结果两组产妇产后血红蛋白和血小板水平均低于生产前,差异有统计学意义（t=15.708 6,P〈0.01;t=18.289 8,P〈0.01;t=2.834 5,P〈0.01;t=4.964 4,P〈0.01）;观察组填塞物放置时间、术中出血量、止血时间、止血有效率、产褥感染率、再次出血率及住院时间均明显优于对照组（t=9.699 1,P〈0.01;t=48.582 7,P〈0.01;t=10.182 1,P〈0.01;χ~2=4.155 1,P〈0.05;χ~2=5.818 5,P〈0.05;χ~2=4.117 7,P〈0.05;t=2.0348,P〈0.05）;所有产妇术后均无腹痛、行动不便等不适症状。结论宫腔尿管联合子宫环形捆绑可用于剖宫产术中产后出血的止血,且能够有效降低产褥感染率和二次出血率,值得在临床上推广应用。

Objective To investigate the effect of intrauterine catheter combined with uterine ring bundle in the treatment of postpartum hemorrhage in cesarean section.Methods A total of 140 patients with postpartum hemorrhage after cesarean section in our hospital from May 2012 to May 2015 were selected and randomly divided into the control group（70cases）and the observation group（70cases）.The control group was treated by intrauterine gauze tamponade combined with the uterine ring bundle;while the observation group was firstly treated by the Foleys double-lumen catheter tamponade of uterine cavity combined with uterine ring bundle.The intraoperative and postoperative conditions were compared between the two groups.The blood routine test results before and after operation were observed and analyzed in the two groups.Results The postpartum hemoglobin and platelet levels in the two groups were significantly lower than before delivery,the difference was statistically significant（t=15.708 6,P〈0.01;t=18.289 8,P〈0.01;t=2.834 5,P〈0.01;t=4.964 4,P〈0.01）;the tamponade placing time,intraoperative bleeding volume,hemostasis time,hemostatic effective rate,puerperal infection rate,rebleeding rate and hospitalization duration in the observation group were significantly better than those in the control group（t=9.699 1,P〈0.01;t=48.582 7,P〈0.01;t=10.182 1,P〈0.01;χ~2=4.155 1,P〈0.05;χ~2=5.818 5,P〈0.05;χ~2=4.117 7,P〈0.05;t=2.034 8,P〈0.05）.All the parturients had no discomfort symptoms of abdominal pain and moving inconvenience after surgery.Conclusion The uterine cavity catheter combined with uterine ring bundle can be used for hemostasis of postpartum hemorrhage in cesarean section,moreover can effectively reduce the puerperal infection rate and secondary hemorrhage rate,which is worthy to be popularized and applied in clinic.