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剖宫产术中止血方法的应用比较

         

摘要

Objective To compare the application effect of B-lynch suture, bilateral uterine artery ligation and uterine packing gauze in cesarean section. Method Selecting cesarean section postpartum hemorrhage 96 cases who delivered at Shenyang Women’s and Children’s Hospital from January 2013 to January 2016, according to surgical hemostasis method, divided into the B-Lynch suture group, bilateral uterine artery ligation group and uterine packing gauze group. The operative time, intraoperative and postoperative bleeding amount, hysterectomy rate, hemostatic treatment efifciency, puerperal morbidity was observed in the three groups.Results ①There was no signiifcant difference in the operative time between the bilateral uterine artery ligation group and B-Lynch suture group(P>0.05), but the operative time of them were both less than uterine packing gauze group (the difference was statistically signiifcant,P<0.05).②There was no signiifcant difference in the amount of bleeding during the operation, but the amount of bleeding of 2 hours after the operation, the amount of bleeding 24 hours after operation in the B-Lynch group was the least, and was signiifcantly lower than that of bilateral uterine artery ligation group and uterine packing gauze group (P<0.05).③There was 1 hysterectomy case in B-Lynch suture group, efifciency of hemostasis was (96.8%); 3 hysterectomy cases in bilateral uterine artery ligation group, efifciency of hemostasis was (93.0%); and 2 hysterectomy cases in uterine packing with gauze group, efifciency of hemostasis was (90.9%). B-lynch suture group, the hemostasis rate is higher than that of the bilateral uterine artery ligation group(P<0.05), no statistical difference between bilateral uterine artery ligation group and tuterine packing gauze group(P>0.05).④No statistical difference (P>0.05) in B-Lynch suture group and bilateral uterine artery ligation group of puerperal disease rate was lower than that of intrauterine packing with gauze group (P<0.05).Conclusion B-lynch suture operation is simple, fast in hemostasis, the effect is ideal, the incidence of related complications is low, it is worth to clinical application.%目的:比较B-lynch缝合术、双侧子宫动脉结扎术、宫腔填塞纱布术在剖宫产术中的应用效果差异。方法选取沈阳市妇婴医院产科2013年1月至2016年1月剖宫产产后出血患者96例,根据止血手术方法分为B-lynch缝合术组,双侧子宫动脉结扎术组、宫腔填塞纱布组。观察三组患者的手术时间,术中出血量、术后出血量,子宫切除率、止血治疗的有效率、产褥病率。结果①双侧子宫动脉结扎术与B-Lynch缝合术手术时间无统计学差异(P>0.05),均少于宫腔填塞纱布术(差异均有统计学意义,P<0.05)。②术中出血量三组之间无统计学差异,术后2 h出血量、术后24 h出血量B-Lynch缝合术组最少,显著低于双侧子宫动脉结扎术组、宫腔填塞纱布组(P<0.05)。③B-lynch缝合组切除子宫1例,止血有效率(96.8%);双侧子宫动脉结扎组切除子宫3例,止血有效率(93.0%);宫腔填塞纱布组切除子宫2例,止血有效率(90.9%)。B-lynch缝合组止血率高于双侧子宫动脉结扎术组(P<0.05),子宫动脉结扎组与宫腔填塞纱布组无统计学差异(P>0.05)。④B-Lynch缝合组与双侧子宫动脉结扎组的产褥病率无统计学差异(P>0.05),均低于宫腔纱布填塞组(P<0.05)。结论 B-lynch缝合术操作简单,止血迅速,效果理想,相关并发症发生率低,值得临床推广应用。

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