子宫下段多方位螺旋式缝合成形术在凶险性前置胎盘手术止血中的应用效果

Hemostasis effects of multiposition spiral suture of lower uterine segment in pernicious placenta previa surgery

目的:探讨子宫下段多方位螺旋式缝合成形术在凶险性前置胎盘(PPP)手术止血中的应用效果。方法:选取60例PPP患者作为研究对象,按照随机数字表法分为观察组和对照组,每组30例。两组均择期行剖宫产手术,观察组予子宫下段多方位螺旋式缝合成形术进行止血,对照组予B-Lynch缝合术+宫腔纱条填塞术进行止血,比较两组手术相关指标(术中出血量、子宫切除率、输血率、子宫动脉栓塞率、手术时间)及术后相关指标(产后24 h出血量、住院时间及恶露持续时间)水平。结果:观察组术中出血量少于对照组,手术时间短于对照组,输血率低于对照组,差异均有统计学意义(P<0.05);两组子宫切除率和动脉栓塞率比较,差异无统计学意义(P>0.05);观察组产后24 h出血量少于对照组,住院时间及恶露持续时间均短于对照组,差异有统计学意义(P<0.05)。结论:PPP手术中采用子宫下段多方位螺旋式缝合成形术止血,可降低输血率和术中出血量,缩短患者住院时间,促进术后恢复。

Objective: To investigate hemostasis effects of multiposition spiral suture of uterine segment in pernicious placenta previa(PPP) surgery. Methods: 60 admitted PPP patients were selected as the research objects, and were divided into observation group and control group according to the random number table method, 30 cases in each group. Both groups underwent elective cesarean section. After that, the observation group was given the multiposition spiral suture of uterine segment, while the control group used B-Lynch suture + uterine cavity gauze packing for hemostasis. The, the operation-related indicators(intraoperative blood loss, hysterectomy rate, blood transfusion rate, uterine artery embolism rate, operation time) and postoperative related indicators(24-hour postpartum hemorrhage, hospitalization time and lochia duration) were compared between the two groups. Results: The intraoperative blood loss in the observation group was less than that in the control group, the operation time was shorter than that in the control group, the blood transfusion rate was lower than that in the control group, and the differences were statistically significant(P<0.05). There were no significant differences in the hysterectomy rate and arterial embolization rate between the two groups(P>0.05). The 24-hour postpartum hemorrhage was less than that in the control group, the hospitalization time and the lochia duration were shorter than those in the control group, and the differences were statistically significant(P<0.05). Conclusions: The application of the multiposition spiral suture of lower uterine segment in the PPP surgery for hemostasis can reduce the blood transfusion rate and intraoperative blood loss, shorten the hospitalization time, and promote the postoperative recovery of these patients.