子宫背带式缝合治疗宫缩乏力性剖宫产手术产后出血的临床效果分析

Clinical Effect Analysis of Uterine Strap Suture in Treatment of Uterine Atony-Caused Postpartum Hemorrhage After Cesarean Section

目的:探讨子宫背带式缝合治疗宫缩乏力性剖宫产手术产后出血的临床效果。方法:选取2021年6月—2022年6月山东省成武县人民医院收治的100例宫缩乏力性剖宫产手术产后出血患者作为研究对象,根据平行对照分组法分为常规组与试验组,各50例。常规组予以宫腔纱布填塞术治疗,试验组予以子宫背带式缝合治疗。比较两组患者围术期止血参数、卵巢血流动力学指数、并发症发生情况、血红蛋白(HGB)水平。结果:试验组术后24 h输血量及出血量、术中输血量及出血量均少于常规组,有效控制出血时间短于常规组,差异有统计学意义(P=0.0000)。治疗后,两组患者收缩期最大血流速度(PSV)、舒张末期血流速度(EDV)均升高,阻力指数(RI)均降低,差异有统计学意义(P<0.05);试验组PSV、EDV高于常规组,RI低于常规组,差异有统计学意义(P=0.0000)。试验组并发症发生率低于常规组,差异有统计学意义(P=0.0039)。治疗后,两组患者HGB水平均降低,但试验组高于常规组,差异有统计学意义(P=0.0000)。结论:宫缩乏力性剖宫产手术产后出血者予以子宫背带式缝合治疗,能显著控制出血问题,稳定恢复进程,可降低并发症发生率,改善卵巢血流动力学指数。

Objective:To explore the clinical effect of uterine strap suture in the treatment of uterine atony-caused postpartum hemorrhage after cesarean section.Methods:A total of 100 patients with postpartum hemorrhage after cesarean section due to uterine atony in Chengwu County People's Hospital of Shandong Province between June 2021 and June 2022 were selected as the study subjects.According to the method of parallel control group,the patients were divided into the conventional group and experimental group,with 50 cases in each group.The conventional group was treated with uterine gauze tamponade,and the experimental group was treated with uterine strap suture.The perioperative hemostatic parameters,ovarian hemodynamic index,complication and hemoglobin(HGB)level of the two groups were compared.Results:The postoperative 24 h blood transfusion volume and blood loss volume,intraoperative blood transfusion volume and blood loss volume in the experimental group were lower than those in the conventional group,and the effective control bleeding time in the experimental group was shorter than that in the conventional group,and the difference was statistically significant(P=0.0000).After treatment,the peak systolic velocity(PSV)and end-diastolic velocity(EDV)increased and the resistance index(RI)decreased in the two groups,and the difference was statistically significant(P<0.05).The PSV and EDV in the experimental group were higher than those in the conventional group,and the RI in the experimental group was lower than that in the conventional group,and the difference was statistically significant(P=0.0000).The incidence of complications in the experimental group was lower than that in the conventional group,and the difference was statistically significant(P=0.0039).After treatment,the HGB level in two groups decreased,but the experimental group was higher than the conventional group,and the difference was statistically significant(P=0.0000).Conclusion:Uterine strap suture in patients with postpartum hemorrhage after cesarean section due to uterine atony can significantly control bleeding problems,stabilize the recovery process,reduce the incidence of complications,and improve ovarian hemodynamic index.