低位子宫下段环扎术在前置胎盘剖宫产术中的应用

Lower uterine segment cerclage for hemorrhage from placenta previa in cesarean section

目的:探讨子宫下段环扎术控制前置胎盘剖宫产术中出血的临床疗效。方法:回顾性分析我院2014年8月~2018年3月前置胎盘手术共74例患者的临床资料,其中采用常规方法手术共24例为对照组,低位子宫下段环扎术共50例为研究组,比较两组患者术中出血量、输血量、手术时间、子宫切除率、术后住院天数,术后并发症等情况。结果:两组患者术中平均出血量、平均输血量、手术时间、子宫切除率比较均有统计学意义(P<0.05);两组术后住院天数均为6~7d,均无并发症发生。结论:前置胎盘剖宫产术中应用低位子宫下段环扎术,具有出血少、并发症少、减少子宫切除等优势,无需特殊材料,不增加患者费用及术后住院天数,值得临床推广。

Objective:To observe the clinical efficacy of lower uterine segment cerclage in management of intra-operative bleeding from placenta previa during cesarean section.Methods:Clinical data were retrospectively analyzed in 74 cases of placenta previa undergone cesarean section in our hospital between August 2014 and March 2018.Of the 74 women,24 received conventional haemostasis(control group),and 50 were managed with lower uterine segment cerclage(observational group).The two groups were compared regarding the volume of intra-operative blood loss and blood transfusion,operative time,hysterectomy rate,days of postoperative hospital stay and postoperative complications.Results:The two groups were significantly different in average volume of intra-operative blood loss and blood transfusion as well as operative time and hysterectomy rate(P<0.05).Postoperative hospital stay ranged from 6 to 7 days,and postoperative complications were free for the two groups.Conclusion:Hemorrhage from placenta previa in cesarean section treated with lower uterine segment cerclage can be lower blood loss,fewer complications and reduced uterine resection rate,which is worthy of clinical recommendation because this treatment does not involve special haemostasis materials leading to added medication of the patients,and will not increase the postoperative stay.