不同缝合方式在前置胎盘剖宫产术宫颈管顽固性出血中的应用

Application of different suture methods in cervical canal intractable hemorrhage in placenta previa cesarean section

目的探讨不同缝合方式在前置胎盘剖宫产术宫颈管顽固性出血中的应用效果。方法选择78例行前置胎盘剖宫产术治疗并发宫颈管顽固性出血患者，根据止血方法分为观察组和对照组，每组39例。对照组行宫颈间断缝合治疗，观察组给予宫颈提拉式缝合，比较两组临床相关指标及止血成功、子宫切除、产褥感染发生情况。结果观察组出血量、术中输血量、手术时间、止血时间及住院时间均少于对照组，差异有统计学意义（P〈0．05）；观察组产褥感染、子宫切除发生率（2．56％、0）均低于对照组（m51％、10．26％），止血成功率（100％）高于对照组（82．05％），差异均有统计学意义（P均〈0.05）。结论给予前置胎盘剖宫产术宫颈管顽固性出血患者宫颈提拉式缝合，可有效减少术后出血量，缩短止血时间及手术时间，提高止血成功率，降低子宫切除及产褥感染发生率，值得临床推广。

Objective To investigate the effects of different suture methods on cervical canal in- tractable hemorrhage in placenta previa cesarean section. Methods Seventy-eight patients who under went placenta previa cesarean section complicated with cervical canal intractable hemorrhage were divided into observation group and control group by hemostasis methods, with 39 cases in each group. Control group was given cervical interrupted suture, while observation group was given cervical hanging suture. The clinical indexes, incidences of successful hemostasis, hysterectomy, puerperal infection were com- pared between the two groups. Results The bleeding volume, intraoperative blood transfusion volume, operation time, hemostasis time and hospital stays in observation group were significantly shorter than those in control group （ P 〈 0. 05 ） ; the incidences of puerperal infection and hysterectomy in observation group （2. 56% , 0） were significantly lower than those in control group （20. 51% , 10. 26% ） , and the success rate of hemostasis in observation group （100%） was higher than that in control group（82.05%, P 〈 0. 05）. Conclusions Cervical hanging suture for patients with cervical canal intractable hemorrhage in placenta previa cesarean section can effectively reduce postoperative bleeding volume, shorten hemo- stasis and operation time, increase the success rate of hemostasis, decrease the incidences of hysterecto- my and puerperal infection, which is worthy of clinical promotion.