肝针缝合在剖宫产术中子宫收缩乏力性出血的临床效果评价

2016-01-21陈青香江西省弋阳县人民医院弋阳334400

上海医药 2015年1期

陈青香(江西省弋阳县人民医院弋阳 334400)

陈青香
(江西省弋阳县人民医院弋阳 334400)

摘要目的：探讨肝针缝合在剖宫产术中子宫收缩乏力性出血的临床效果。方法：选取我院收治的行剖宫产分娩且术中发生子宫收缩乏力性出血产妇168例，随机分为观察组72例、对照A组46例和对照B组50例，分别给予肝针缝合、宫腔填塞和盆腔血管结扎止血治疗，比较3组产妇手术时间、术中出血量、切除子宫率、术后感染率、二次手术率以及输血率。结果：观察组产妇中这些指标均明显低于对照A、B两组 (P＜0.05)；术后随访9个月，3组产妇均未再出血，B超复查未见异常，无明显并发症，月经均在5～9个月内恢复。结论：剖宫产术中子宫收缩乏力性出血时采取肝针缝合止血能够有效减少产妇术中出血量、缩短手术时间、降低切除子宫率、术后感染率、二次手术率以及输血率，临床应用价值较高。

关键词肝针缝合剖宫产子宫收缩乏力性出血

Evaluation of the clinical effect of hepatic needle suture
on the contraction asthenia hemorrhage of uterine in cesarean section delivery

CHEN Qingxiang
(The People’s Hospital of Yiyang County, Jiangxi province, Yiyang 334400, China)

ABSTRACTObjective: To investigate the clinical effect of hepatic needle suture on uterine atony bleeding in cesarean section delivery. Methods: One hundred and sixty-eight cases of puerperae with uterine atony bleeding in cesarean section delivery in our hospital were selected and randomly divided into an observation group with 72 cases, a control group A with 46 cases and a control group B with 50 cases, to which hepatic needle suture, packing in uterine cavity and pelvic vessel ligation were given, respectively，and maternal operative time, blood loss, hysterectomy rate, postoperative infection, reoperation rate and blood transfusion rate were compared among three groups. Results: These indexes were significantly lower in the observation group than in the control group A and B (P<0.05). Hemorrhage was not found in all cases during 9 months of postoperative follow-up, no abnormalities were found either in B ultrasonic examination and no obvious complications occurred, and the menstruation was recovered in 5~9 months. Conclusion: All the indexes above-mentioned can be reduced by hepatic needle suture when the contraction asthenia hemorrhage of uterine in cesarean section delivery occurred, which has a higher value of application in clinic.

KEY WORDShepatic needle suture; cesarean section; uterine atony bleeding

产后出血是导致产妇死亡的主要危险因素，其中剖宫产术中子宫收缩乏力性出血在产后出血中较为常见，及时控制出血是降低这类产妇死亡率的关键[1]。临床上一般采取按摩、促宫缩药物、宫腔填塞纱条以及子宫动脉结扎等方式进行止血。我院在剖宫产术中对子宫收缩乏力性出血采用肝针缝合止血，临床效果满意，现报道如下。