产后出血经子宫背带式缝合术对出血量、手术时间及产褥病发生率的影响

Effect of postpartum hemorrhage on hemorrhage,operation time and incidence of psoriasis by uterine belt suture

目的:探讨子宫背带式缝合术对产后出血患者术后出血量、手术时间及产褥病发生率的影响。方法:选取2013年11月至2016年6月常州市金坛区人民医院84例产后出血患者,随机数字表法分为对照组(n=42)与研究组(n=42)。对照组采用常规止血措施,研究组采用子宫背带式缝合术。统计对比两组围术期相关指标(手术时间、术后出血量、下床活动时间、住院时间)情况、治疗效果、产褥病发生率及子宫切除率、并发症发生率、治疗前后生活质量评分(SF-36)变化情况。结果:研究组手术时间、术后出血量、下床活动时间、住院时间较对照组少,差异具有统计学意义(P<0.05);两组治疗有效率比较,研究组92.86%(39/42)较对照组73.81%(31/42)高,差异具有统计学意义(P<0.05);研究组产褥病发生率7.14%(3/42)较对照组26.19%(11/42)低,差异具有统计学意义(P<0.05),研究组子宫切除率0.00%(0/42)与对照组4.76%(2/42)相比,差异无统计学意义(P>0.05);研究组治疗前SF-36分值与对照组比较,差异无统计学意义(P>0.05),治疗后研究组SF-36评分与治疗前无明显变化,对照组SF-36分值较治疗前降低,且治疗后研究组SF-36分值较对照组高,差异具有统计学意义(P<0.05);两组并发症发生率比较,研究组9.52%(4/42)较对照组28.57%(12/42)低,差异具有统计学意义(P<0.05)。结论:采用子宫背带式缝合术治疗产后出血效果显著,可有效缩短手术用时,减少出血量,提高治疗效果,降低产褥病及并发症发生率,促使患者及早康复,提高其生活质量,具有推广价值。

Objective： To explore the effect of uterine strap type suture on the postoperative bleeding volume,operation time and the incidence of puerperal disease in patients with postpartum hemorrhage. Methods： 84 patients with postpartum hemorrhage in Jintan District People＇s Hospital from November 2013 to June 2016 were randomly divided into control group and study group,42 cases in each group. The control group was treated with conventional hemostasis,and the study group was treated with uterine strap type suture. Perioperative related indicators （operation time,amount of postoperative blood loss,time to get out of bed,hospital stay）,treatment effect,the incidence of puerperal disease and hysterectomy,the incidence of complications and changes in quality of life before and after treatment （SF-36） of the two groups were compared. Results： The operative time,the amount of postoperative blood loss,the time of getting out of bed and the length of hospital stay in the study group were all less than those in the control group,with statistically significant difference （P〈 0. 05）. The effective rate of the study group （92. 86%,39/42） was higher than that of the control group （73. 81%,31/42）,with statistically significant difference （P〈 0. 05）. The incidence of puerperal disease in the study group was （7. 14%,3/42） lower than that in the control group （26. 19%,11/42）,with statistically significant difference （P〈 0. 05）. There was no significant difference in the hysterectomy rate between the study group （0. 00%,0/42） and the control group （4. 76%,2/42） （P〉 0. 05）. Before treatment,the scores of SF-36 in the study group were not significantly different from those in the control group （P〉 0. 05）,while after treatment,the SF-36 score of the study group was not significantly changed compared with that before treatment,but the SF-36 score of the control group was lower than that before treatment,and the scores of SF-36 in the study group were higher than those in the control group,with statistically significant difference （P〈 0. 05）. The incidence of complications in the study group was （9. 52%,4/42）lower than that in the control group （28. 57%,12/42）,with statistically significant difference （P〈 0. 05）.Conclusions： The uterine strap type suture has significant effect in the treatment of postpartum hemorrhage,which can effectively shorten the operation time,reduce the amount of blood loss,improve the treatment effect,reduce the incidence of puerperal diseases and complications,prompt the recovery of patients and improve their quality of life,thusly worth of promotion.