赵莉敏+李世荣+陈绪兰

[摘要]目的 比較分析联合宫腔水囊填塞、宫腔钳夹及阴道纱条填塞在产后出血治疗中的应用价值。方法 随机选择2013年1月～2015年12月我院收治的120例阴道分娩产后出血患者，并将其分为三组，每组40例，其中接受联合宫腔水囊填塞及阴道纱条填塞治疗者为A组，接受联合宫腔水囊填塞及宫腔钳夹治疗者为B组，接受联合宫腔水囊填塞、宫腔钳夹及阴道纱条填塞治疗者为C组。比较三种方法在产后出血治疗中的应用效果。结果 三组分娩中出血量、产后24 h出血量、止血时间及填充物留置时间比较，差异有统计学意义（P<0.01），C组分娩出血量及产后24 h出血量少于A组及B组，止血时间及填充物留置时间短于A组及B组（P<0.05），而A组与B组比较，差异无统计学意义（P>0.05）。同时，三组产后并发症发生率比较差异无统计学意义（P>0.05）。结论 联合宫腔水囊填塞、宫腔钳夹及阴道纱条填塞三种治疗方法可显著提高产后出血的临床治疗效果。

[关键词]宫腔水囊填塞；宫腔钳夹；阴道纱条填塞；产后出血

[中图分类号] R714.461 [文献标识码] A [文章编号] 1674-4721（2016）12（b）-0084-03

Clinical effect of combination application of intrauterine water sac packing，uterine forceps and vaginal gauze in the treatment of postpartum hemorrhage

ZHAO Li-min LI Shi-rong CHEN Xu-lan

Department of Obstetrics and Gynecology，Sanxiang Hospital of Zhongshan，Guangdong Province Zhongshan 528463，China

[Abstract]Objective To compare the effect of combination application of intrauterine water sac packing，uterine forceps and vaginal gauze in the treatment of postpartum hemorrhage.Methods One hundred and twenty patients with postpartum hemorrhage who were treated from January 2013 to December 2015 in our hospital were randomly selected and divided into three groups，with 40 cases in each group.Patients who received the combined treatment of intrauterine water sac packing and vaginal gauze were selected as group A；patients who received the combined treatment of intrauterine water sac packing and uterine forceps were selected as group B；patients who were treated with the combination of intrauterine water sac packing，uterine forceps and vaginal gauze were selected as group C.The effect of three groups in the treatment of postpartum hemorrhage was compared.Results Statistically significant difference was seen in the childbirth bleeding volume and postpartum 24 h bleeding volume，hemostasis time and filler retention time of the three groups，the differences were statistically significant （P<0.01）；group C had lower childbirth bleeding volume and postpartum 24 h bleeding volume as well as shorter hemostasis time and filler retention time in comparison with group A and group B，the differences were statistically significant （P<0.05）；there was no significant difference between group A and group B （P>0.05）.At the same time，there was no significant difference in the incidence of postpartum complications between the three groups （P>0.05）.Conclusion Combination application of intrauterine water sac packing，uterine forceps and vaginal gauze can significantly improve the clinical effect of the treatment of postpartum hemorrhage.

[Key words]Intrauterine water sac packing；Uterine forceps；Vaginal gauze；Postpartum hemorrhage

产后出血为分娩过程中最为严重的并发症之一，是指在胎儿娩出后24 h内阴道出血量超过500 ml，为导致产妇死亡的最主要原因之一[1-2]。目前临床可应用于产后出血治疗的方法主要有药物缩宫止血、子宫按摩、宫腔填塞、子宫缝合、血管栓塞及子宫切除等多种，但各种治疗方法所达到的治疗效果也存在一定的差异[3-5]。而为了更为有效地提高产后出血的临床治疗效果，本研究在产后出血的治疗中将宫腔水囊填塞、宫腔钳夹及阴道纱条填塞进行联合应用，结果总结报道如下。