橡胶带捆绑子宫下段在极高危产后出血剖宫产产妇子宫缝扎术中的应用效果

The Effect of Rubber Band Binding the Lower Portion of Uterus in the Hysterectomy of Women with High Risk Postpartum Hemorrhage During Caesarean Section

目的 探讨橡胶带捆绑子宫下段在极高危产后出血剖宫产产妇子宫缝扎术中的应用效果。方法 选取2020年1月至2023年8月期间湘潭市妇幼保健院产科收诊的具有产后出血极高危因素的剖宫产产妇60例,以随机数字表法将患者分为对照组和研究组,每组30例。对照组应用子宫缝扎术止血,研究组采用T型橡胶引流管捆绑子宫下段并同时快速行子宫缝扎术止血。比较两组手术指标及分娩结局、术后恢复及住院情况、血红蛋白(Hb)、生化指标及并发症发生情况。结果 研究组手术时间短于对照组,输血量及术中失血量低于对照组(P <0.05)。与对照组相比,研究组住院时间缩短,术后24 h累计出血量及住院费用较低(P <0.05)。与术前相比,术后两组Hb值、术后修正Hb值下降(P <0.05);两组术前、术后的Hb值比较,差异无统计学意义(P> 0.05),术后修正Hb值则研究组较高(P <0.05)。与术前相比,术后两组白细胞计数(WBC)及中性粒细胞绝对值(Neu)水平升高(P <0.05),研究组WBC、Neu水平偏低(P <0.05)。两组并发症发生情况比较,差异无统计学意义(P> 0.05),经治疗后均有所好转,无死亡病例。结论 橡胶带捆绑子宫下段在极高危产后出血剖宫产产妇子宫缝扎术中的应用可获得较好的止血效果,可显著减少出血量及输血量,减少并发症的发生。

Objective To investigate the application effect of rubber band binding the lower portion of uterus in the hysterectomy of women with high risk postpartum hemorrhage during caesarean section.Methods A total of 60 patients with high risk factors for postpartum hemorrhage admitted to the obstetrics department of Xiangtan Maternal and Child Health Hospital from January 2020 to August 2023 were selected and divided into control group and study group by random number table method,with 30 cases in each group.The control group was treated with uterine suture for hemostasis,while the study group was treated with T-shaped rubber drainage tube for binding the lower segment of the uterus and rapid uterine suture for hemostasis at the same time.The surgical indexes,delivery outcomes,postoperative recovery and hospitalization,hemoglobin(Hb),blood image indexes and complications were compared between the two groups.Results The operation time of the study group was shorter than that of the control group,and the blood transfusion and intraoperative blood loss were lower than those of the control group(P<0.05).Compared with the control group,the duration of hospital stay in the study group was shorter,and the accumulated blood loss and hospitalization cost were lower 24 h after surgery(P<0.05).Compared with preoperative,postoperative Hb value and postoperative modified Hb value in 2 groups decreased(P<0.05).There was no significant difference in Hb value between the two groups before and after surgery(P>0.05),while the Hb value corrected after surgery was higher in the study group(P<0.05).Compared with pre-operation,the levels of white blood cell count(WBC)and neutrophil absolute value(Neu)were increased in the 2 groups after operation(P<0.05),while the levels of WBC and Neu in the study were lower(P<0.05).There was no statistical significance in the occurrence of complications between the two groups(P>0.05).After treatment,both groups were improved,and there was no death case.Conclusions The application effect of rubber band binding the lower portion of uterus in the hysterectomy of women with high risk postpartum hemorrhage during caesarean section,can significantly reduce the amount of blood loss and blood transfusion,reduce the incidence of complications.