改良Cho缝合术结合水囊填塞压迫止血对凶险性前置胎盘患者产后出血、凝血功能及卵巢功能的影响

Effects of modified Cho suture combined with water sac packing and compression hemostasis on postpartum hemorrhage,coagulation function and ovarian function in patients with dangerous placenta previa

目的探讨改良Cho缝合术结合水囊填塞压迫止血对凶险性前置胎盘患者产后出血、凝血功能及卵巢功能的影响。方法根据不同治疗方案将2018年9月至2020年12月收治的80例凶险性前置胎盘患者分为对照组与观察组,各40例。对照组采取Cho缝合术结合水囊填塞压迫止血,观察组采取改良Cho缝合术结合水囊填塞压迫止血。比较两组的干预效果。结果观察组产后2、24 h的出血量及输血量少于对照组,住院时间短于对照组(P<0.05)。产后24 h,观察组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,D-二聚体(D-D)、纤维蛋白原(Fib)水平高于对照组(P<0.05)。产后24 h,两组的抗缪勒管激素(AMH)、雌二醇(E2)、卵泡刺激素(FSH)水平比较,差异无统计学意义(P>0.05)。结论改良Cho缝合术结合水囊填塞压迫止血可减少凶险性前置胎盘患者产后出血量及输血量,缩短住院时间,也能调节凝血功能,且不会增加卵巢损伤风险。

Objective To explore the effects of modified Cho suture combined with water sac packing and compression hemostasis on postpartum hemorrhage,coagulation function and ovarian function in patients with dangerous placenta previa.Methods Eighty patients with dangerous placenta previa admitted from September 2018 to December 2020 were divided into control group and observation group according to different treatment regimes,with 40 cases in each group.The control group was treated with Cho suture combined with water sac packing and compression hemostasis,and the observation group was treated with modified Cho suture combined with water sac packing and compression hemostasis.The intervention effects of the two groups were compared.Results The bleeding volume at 2 and 24 h after delivery and blood transfusion volume in the observation group were less than those in the control group,and the hospital stay was shorter than that in the control group(P<0.05).At 24 h after delivery,the prothrombin time(PT)and activated partial thromboplastin time(APTT)in the observation group were shorter than those in the control group,and the levels of D-dimer(D-D)and fibrinogen(Fib)were higher than those in the control group(P<0.05).There were no significant differences in the levels of anti-Müllerian hormone(AMH),estradiol(E2)and follicle-stimulating hormone(FSH)between the two groups at 24 h after delivery(P>0.05).Conclusion The modified Cho suture combined with water sac packing and compression hemostasis can reduce the amount of postpartum hemorrhage and blood transfusion of patients with dangerous placenta previa,shorten the hospital stay,regulate the coagulation function,and will not increase the risk of ovarian injury.