子宫捆绑术联合子宫动脉结扎术治疗产后出血的临床效果

Clinical effect of uterine ligature combined with uterine artery ligation in the treatment of postpartum hemorrhage

目的探讨产后出血采用子宫捆绑术联合子宫动脉结扎术治疗的临床效果。方法选取86例产后出血患者,根据随机数字表法分为对照组与试验组,各43例。对照组给予子宫动脉结扎术治疗,试验组在对照组基础上联合子宫捆绑术治疗。比较两组术中及术后出血量、术前及术后血常规指标、卵巢血流指标、并发症发生情况。结果试验组术中、术后12h、24h出血量均少于对照组,差异有统计学意义(P<0.05)。术前,两组红细胞计数、血红蛋白水平比较,差异无统计学意义(P>0.05);术后,两组红细胞计数、血红蛋白水平均低于术前,但试验组明显高于对照组,差异有统计学意义(P<0.05)。术前,两组血流阻力指数(RI)、收缩期血流速度(PSV)、舒张期血流速度(EDV)指标比较,差异无统计学意义(P>0.05);术后,两组RI、PSV、EDV指标均较治疗前改善,且试验组RI指标低于对照组,PSV、EDV指标高于对照组,差异有统计学意义(P<0.05)。试验组并发症发生率(4.65%)低于对照组(18.60%),差异有统计学意义(P<0.05)。结论产后出血患者给予子宫捆绑术联合子宫动脉结扎术治疗,可有效止血,降低贫血风险,改善卵巢供血,减少并发症发生,值得临床推广。

Objective To investigate the clinical effect of uterine binding combined with uterine artery ligation on postpartum hemorrhage.Methods 86 patients with postpartum hemorrhage were selected and divided into control group and experimental group(43 cases each)according to random number table method.The control group was treated with uterine artery ligation,and the experimental group was treated with uterine binding based on the control group.Intraoperative and postoperative blood loss,preoperative and postoperative blood routine indexes,ovarian blood flow indexes and complications were compared between the two groups.Results The blood loss of experimental group during operation,12 h and 24 h after operation was lower than that of control group,and the difference was statistically significant(P<0.05).Before operation,there was no significant difference in red blood cell count and hemoglobin index between the two groups(P>0.05).After operation,the levels of red blood cell count and hemoglobin index in both groups were lower than before operation,and the test group was significantly higher than the control group,the difference was statistically significant(P<0.05).Before operation,there was no significant difference in the indexes of flow resistance index(RI),systolic flow velocity(PSV)and diastolic flow velocity(EDV)between the two groups(P>0.05).After surgery,RI,PSV and EDV indexes in both groups were improved compared with those before treatment,and RI indexes in experimental group were lower than those in control group,while PSV and EDV indexes were higher than those in control group,with statistical significance(P<0.05).The complication rate of experimental group(4.65%)was lower than that of control group(18.60%),and the difference was statistically significant(P<0.05).Conclusion Uterine binding combined with uterine artery ligation can effectively stop bleeding,reduce the risk of anemia,improve ovarian blood supply and reduce complications,which is worth popularizing.