VIP-CS缝合技术在前置胎盘合并重型植入中的应用

Application of vessel interruption and perfoliate compression suture suture in placenta previa with severe implantation

目的研究血管纵横阻断缝合技术(VIP-CS)在前置胎盘合并重型植入患者中的应用价值。方法选取2017年4月至2018年4月在兴平市妇幼保健院就诊的前置胎盘合并重型植入40例患者进行研究,按照随机数表法将患者分为观察组与对照组各20例。对照组患者采用常规方法止血,观察组患者采用VIP-CS缝合技术止血。比较两组患者术后的止血效果、手术时间、住院时间、术中出血量、术后1 d出血量和术后并发症的发生情况。结果观察组患者的止血效果总有效率为100.0%,明显高于对照组的80.0%,差异有统计学意义(P<0.05);观察组患者的手术时间、止血时间、住院时间分别为(32.24±16.33) min、(7.14±3.11) min、(11.14±2.43) d,明显短于对照组的(98.22±13.53) min、(12.24±2.13) min、(19.25±3.43) d,差异均有统计学意义(P<0.05);观察组患者的术中出血量、术后1 d出血量分别为(324.24±36.43) m L、(354.24±36.43) mL,明显低于对照组的(598.24±43.57) mL、(689.74±31.57) mL,差异均有统计学意义(P<0.05);观察组患者的子宫复旧率、子宫切除率分别为5.0%、0,明显低于对照组的30.0%、25.0%,差异均有统计学意义(P<0.05);观察组患者术后并发症发生率为5.0%,明显低于对照组的30.0%,差异有统计学意义(P<0.05)。结论前置胎盘合并重型胎盘植入患者术中采用VIP-CS缝合技术具有良好的止血效果,且手术时间较短,出血量少,操作简易,高效,可有效避免术后并发症的发生,保证患者安全,值得临床推广应用。

Objective To study the application value of vessel interruption and perfoliate compression suture(VIP-CS) in patients with placenta previa and severe implantation. Methods From April 2017 to April 2018, 40 patients with placenta previa and severe implantation who were treated in the Maternal and Child Health Hospital of Xingping City were divided into observation group and control group according to the random number table method, with 20 patients in each group. The control group was treated with routine hemostasis, and the observation group was treated with VIP-CS suture technology. The hemostasis effect, operation time, hospitalization time, intraoperative bleeding volume, bleeding volume 1 day after operation and postoperative complications were compared between the two groups.Results The total effective rate of hemostasis in the observation group was 100.0%, which was significantly higher than 80.0% in the control group(P<0.05). The operation time, hemostasis time, and hospitalization time of the observation group were(32.24±16.33) min,(7.14±3.11) min, and(11.14±2.43) d, respectively, which were significantly lower than(98.22±13.53) min,(12.24±2.13) min, and(19.25±3.43) d of the control group(P<0.05). The intraoperative bleeding volume, bleeding volume 1 day after operation in the observation group were(324.24±36.43) m L,(354.24±36.43) mL, which were significantly lower than(598.24±43.57) mL,(689.74±31.57) mL in the control group(P<0.05). The rates of uterine involution and hysterectomy in the observation group were 5.0% and 0, which were significantly lower than 30.0% and25.0% in the control group(P<0.05). The incidence of postoperative complications in the observation group was 5.0%,which was significantly lower than 30.0% in the control group(P<0.05). Conclusion VIP-CS suture has good hemostasis effect in the operation of placenta previa combined with severe placental implantation, with short operation time,small amount of bleeding, simple operation, and significant efficacy, which can effectively avoid the occurrence of postoperative complications, ensure the safety of patients, and is worthy of clinical application.