“U”字缝合联合止血带治疗凶险性前置胎盘出血的效果

U-shape suture combined with tourniquet in treatment of pernicious placenta previa hemorrhage

目的探讨"U"字缝合联合止血带治疗凶险性前置胎盘(PPP)出血的临床效果。方法回顾性分析2013年10月至2018年10月245例PPP出血患者的临床资料。根据止血方法分组:对照组(120例)行常规处理联合"U"字缝合,研究组(125例)在对照组基础上联用止血带。比较两组治疗效果。结果研究组止血有效120例,有效率为96.00%,对照组止血有效102例,有效率为85.00%,研究组止血有效率显著高于对照组(χ^(2)=8.709,P<0.01)。研究组子宫切除率显著低于对照组,差异有统计学意义(1.60%vs 14.17%,χ^(2)=13.516,P<0.01)。研究组止血时间短于对照组,术中出血量、术中输血量及术后24 h出血量均少于对照组(P<0.01)。两组术中均未出现相关并发症。研究组术后并发症发生率低于对照组(2.40%vs 10.00%,χ^(2)=6.153,P<0.05)。研究组恶露持续时间显著短于对照组[(25.21±3.65)d vs(29.35±3.34)d,t=9.251,P<0.01]。结论 PPP出血患者应用"U"字缝合联合止血带可改善止血效果,缩短止血时间,减少出血量,降低子宫切除及并发症发生风险,促进术后恢复。

Objective To investigate the clinical effect of U-shape suture combined with tourniquet on pernicious placenta previa(PPP)hemorrhage.Methods The clinical data of 245 patients with PPP hemorrhage treated from October 2013 to October 2018 were retrospectively analyzed.According to the hemostatic methods,120 patients in control group were treated with routine treatment combined with U-shape suture,and 125 patients in study group were treated with tourniquet on the basis of the regimen of control group.The therapeutic effects were compared between two groups.Results The effective rate of hemostasis in study group was significantly higher than that in control group(96.00%vs 85.00%,χ^(2)=8.709,P<0.01).The hysterectomy rate in study group was significantly lower than that in control group(1.60%vs 14.17%,χ^(2)=13.516,P<0.01).The hemostasis time,the intraoperative blood loss,postoperative bleeding volume within 24 h and intraoperative blood transfusion volume in study group were significantly lower than those in control group(P<0.01).No complications occurred during the operation in both groups.The incidence of postoperative complications in study group was statistically lower than that in control group(2.40%vs 10.00%,χ^(2)=6.153,P<0.05).The duration of lochia discharge in study group was significantly shorter than that in control group[(25.21±3.65)d vs(29.35±3.34)d,t=9.251,P<0.01].Conclusion In the treatment of PPP hemorrhage,U-shape suture combined with tourniquet can improve the hemostatic effect,shorten the hemostasis time,reduce the bleeding volume,the risk of hysterectomy and complications and promote postoperative recovery.