子宫压缩缝合术防治剖宫产后出血的效果分析

Effect of uterine compression suture in the prevention and treatment of postpartum hemorrhage of cesarean section

目的 分析子宫动脉结扎术联合改良式子宫压缩缝合术防治剖宫产产后出血的临床效果.方法 将符合难治性剖宫产产后出血患者并采用子宫动脉结扎术联合改良式子宫压缩缝合术治疗的患者107例纳入治疗组,以同期采用传统治疗方法的患者83例纳入对照组.比较两组有效止血率、临床疗效、切口感染、产后出血量、输血率、产褥病率及术后患病等情况的差异.结果 治疗组术中出血量（1 106±458.78） mL,多于对照组的（753.60±302.30） mL,差异有统计学意义（t=1.892,P＜0.05）;治疗组24 h总出血量（1 028.89±375.87） mL,多于对照组的（813.87±312.15） mL,差异有统计学意义（t=3.872,P＜0.05）;治疗组术后24h内出血量（70.86±19.30） mL,少于对照组的（73.50±21.20） mL,差异无统计学意义（t=0.045,P＞0.05）;治疗组输血率27.10％,高于对照组的10.84％,差异有统计学意义（x2 =7.722,P＜0.05）;治疗组有效止血率99.66％（106/107）,高于对照组的96.39％,差异有统计学意义（x2=6.263,P＜0.05）.术后随访,治疗组产褥感染率7.48％,对照组为6.02％,两组差异无统计学意义（P＞0.05）.治疗组和对照组的切口感染率和术后患病率均为0.00％,两组切口均为Ⅱ/甲愈合.结论 应用子宫动脉结扎术联合改良式子宫压缩缝合术,防治剖宫产产后出血止血效果好,子宫切除率低,值得推广应用.

Objective To analyze the clinical effect of uterine artery ligation combined with modified uterine compression suture in the prevention and treatment of postpartum hemorrhage.Methods A total of 107 patients with refractory cesarean section who were treated with uterine artery ligation combined with modified uterine compression suture were selected as treatment group.Of the patients treated with conventional treatment,83 patients were included in the control group.The effective hemostasis rate,clinical curative effect,incision infection,postpartum hemorrhage,blood transfusion rate,mattress rate and postoperative morbidity were compared between the two groups.Results The amount of intraoperative blood loss （1 106 ± 458.78） mL in the treatment group was significantly higher than （753.6 ±302.30）mL in the control group,the difference was statistically significant （t =1.892,P ＜ 0.05）.The 24h total blood loss of the the treatment group [（1 028.89 ± 375.87） mL] was significantly higher than （813.87 ± 312.15） mL of the control group （t =3.872,P ＜ 0.05）.The postoperative 24h blood loss in the treatment group [（70.86 ±19.30）mL] was lower than （73.50 ± 21.20）mL in the control group,and the difference was not statistically significant （t =0.045,P ＞ 0.05）.The transfusion rate in the treatment group was 27.10％,which in the control group was higher than 10.84％,the difference was statistically significant between the two groups （x2 =7.722,P ＜ 0.05）.The effective hemostasis rate in the treatment group was 99.66％ （106/107）,which was significantly higher than 96.39％ in the control group （x2 =6.263,P ＜ 0.05）.The rate of puerperal infection was 7.48％ in the treatment group,which in the control group was 6.02％,there was no significant difference between the two groups （P ＞ 0.05）.The incision infection rate and postoperative morbidity rate were 0.00％ in the treatment group and the control group,and the two groups were treated with Ⅱ / A healing.Conclusion Uterine artery ligation combined with improved uterine compression suture in the prevention and treatment of postpartum hemorrhage has good hemostasis effect,hysterectomy rate is low,it is worthy of promoting and application.