全子宫捆绑缝合术在剖宫产难治性大出血产妇中的应用效果分析

Analysis of the Application Effect of Total Uterine Binding Suture in Women with Refractory Hemorrhage in Cesarean Delivery

目的:分析全子宫捆绑缝合术在剖宫产难治性大出血产妇中的应用效果。方法:选取2021年1月—2022年12月于福泉市第一人民医院产科行剖宫产术后出现难治性大出血的产妇70例作为研究对象,按照随机数字表法分为对照组和研究组,各35例。对照组行宫内球囊压迫止血,研究组行全子宫捆绑缝合术止血。比较两组手术相关指标、治疗效果、血清性激素水平、子宫血流动力学参数。结果:研究组手术时间短于对照组,术中、术后2h、术后24h出血量少于对照组,差异有统计学意义(P<0.05);研究组治疗有效率高于对照组,差异有统计学意义(P=0.044);产后42d、6个月,两组血清卵泡刺激素、黄体生成素、雌二醇水平比较,差异无统计学意义(P>0.05);两组左右侧子宫动脉血管阻力指数和收缩期与舒张期流速比比较,差异无统计学意义(P>0.05)。结论:全子宫捆绑缝合术在剖宫产难治性大出血产妇中的应用效果显著,可有效缩短手术时间,降低出血量,且不影响产妇的性激素水平和子宫功能。

Objective:To analyze the application effect of total uterine binding suture in women with refractory hemorrhage in cesarean delivery.Methods:Seventy cases of women with refractory hemorrhage after cesarean delivery in the Department of Obstetrics of Fuquan First People's Hospital from January 2021 to December 2022 were selected as the study subjects,and they were divided into the control group and the study group according to the method of randomized numerical table,with thirty-five cases in each group.In the control group,intrauterine balloon compression was performed to stop hemorrhage,and in the study group,total uterine binding suture was performed to stop hemorrhage.Surgery-related indexes,therapeutic effects,serum sex hormone levels,and uterine hemodynamic parameters were compared between the two groups.Results:The operation time of the study group was shorter than that of the control group,and the intraoperative,postoperative 2 h,and postoperative 24 h bleeding was less than that of the control group,and the difference was statistically significant(P<0.05);the treatment efficiency of the study group was higher than that of the control group,and the difference was statistically significant(P=0.044);at 42 d and 6 months postpartum,the comparison of serum follicle-stimulating hormone,luteinizing hormone,and estradiol levels between the two groups was not statistically significant(P>0.05);the comparison of vascular resistance index of right and left side uterine arteries and systolic to diastolic flow rate ratio between the two groups was not statistically significant(P>0.05).Conclusion:The application of total uterine binding suture in women with refractory hemorrhage in cesarean delivery is remarkable,which can effectively shorten the operation time,reduce the bleeding volume,and does not affect the maternal sex hormone level and uterine function.