全子宫捆绑缝合在前置胎盘孕妇剖宫产术中的应用

Complete uterine bundle suture at cesarean section in pregnant women with placenta previa

目的探讨全子宫捆绑缝合术在前置胎盘孕妇剖宫产术中的临床应用价值。方法选择2017年1月至2018年1月收治的并发前置胎盘并接受子宫下段剖宫产术的56例孕妇,根据数字表法随机分为对照组和观察组,每组28例。对照组实施子宫下段剖宫产术联合经典B-Lynch缝合术;观察组实施子宫下段剖宫产术联合全子宫捆绑缝合术。对比两组临床疗效、术后并发症发生率、子宫复旧情况、月经恢复情况及性激素水平。结果观察组有效率显著高于对照组(100. 00%vs 71. 43%,χ~2=7. 146,P=0. 008)。观察组手术时间短于对照组,术中、术后2 h、术后24 h失血量和产后出血发生率均低于对照组,差异有统计学意义(P<0. 05,P<0. 01)。两组均无严重术后并发症。两组产后42 d与产后6个月卵泡刺激素、黄体生成素、雌二醇组内、组间比较均无统计学差异(P>0. 05)。随访1年,两组患者均已月经复潮,月经恢复时间、月经量和月经周期比较均无统计学差异(P>0. 05)。结论全子宫捆绑缝合术可以安全有效的减少前置胎盘孕妇剖宫产术后产后出血的发生。

Objective To explore the application value of complete uterine bundle suture at cesarean section in pregnant women with placenta previa. Methods Fifty-six pregnant women with placenta previa receiving lower uterine cesarean section from January 2017 to January 2018 were randomly divided into control group and observation group(n = 28,each).The lower uterine cesarean section combined with classic B-Lynch suture was performed in control group,and the lower uterine cesarean section combined with complete uterine bundle suture was conducted in observation group. The incidence of postoperative complications,uterine involution,menstrual recovery and sex hormone levels were compared between two groups. Results The effective rate in observation group was significantly higher than that in control group(100. 00% vs71. 43%,χ~2= 7. 146,P = 0. 008). Compared with control group,the operation time,intraoperative blood loss,postoperative 2-and 24-h blood loss and the incidence of postpartum hemorrhage significantly decreased in observation group(P< 0. 05,P< 0. 01). No serious complications occurred in both groups. There were no significant differences in the levels of luteinizing hormone,follicle stimulating hormone and estradiol between two groups(P >0. 05). One-year follow-up results showed that the patients had recovered the normal menstruation in two groups,and there were no significant differences in menstrual recovery time,menstrual volume and menstrual cycle(P >0. 05). Conclusion The complete uterine bundle suture can reduce the incidence of postpartum hemorrhage after cesarean section safely and effectively in pregnant women with placenta previa.