摘要
目的探索宫腔填塞联合水囊压迫止血在凶险性前置胎盘治疗中的临床疗效。方法选取2013年9月至2015年4月广东省东莞市厚街医院救治的48例凶险型前置胎盘患者为对照组,同时选取2015年5月至2016年12月于该院接受治疗的38例凶险型前置胎盘患者为观察组,对照组采用"8"字缝合及子宫动脉上行支结扎治疗,观察组采用宫腔填塞联合水囊压迫止血治疗。严密观察患者术后24小时出血量、48小时出血量、取出水囊及纱布后阴道流血量,统计患者再出血发生率、弥散性血管内凝血(DIC)发生率、子宫切除率及术后出现的不良反应。结果观察组术后24小时出血量、术后48小时出血量及取出水囊及纱布后阴道流血量均显著低于对照组(t值分别为1.879、2.086、2.145,均P<0.05)。观察组再出血发生率、DIC发生率及子宫切除率均显著低于对照组(χ~2值分别为4.617、5.024、4.849,均P<0.05)。观察组患者总不良反应发生率显著低于对照组(χ~2=4.876,P<0.05)。结论宫腔填塞联合水囊压迫止血在凶险性前置胎盘治疗中止血效果显著,再出血发生率、DIC发生率及子宫切除率较低。
Objective To explore the clinical efficacy of uterine packing combined with water sac compression hemostasis in the treatment of pernicious placenta previa.Methods A total of 48 patients with pernicious placenta previa during September 2013 to April 2015 treated in Houjie Hospital of Dongguan City in Guangdong Province were selected as control group,while 38 patients of pernicious placenta previa during May 2015 to December 2016 treated in the hospital were selected as observation group.The patients in the control group adopted 8-shaped suture and uterine artery ligation therapy,while the patients in the observation group were treated with uterine packing combined with water sac compression hemostasis.The amount of bleeding in 24,48 hours after operation and the amount of vaginal bleeding after taking out the water sac and gauze were closely observed.The incidence of rebleeding,incidence of disseminated intravascular coagulation（DIC）,rate of hysterectomy and the postoperative adverse reactions were counted.Results The amount of bleeding in 24,48 hours after operation and the amount of vaginal bleeding after taking out the water sac and gauze of the patients in the observation group were significantly lower than those of patients in the control group（t value was 1.879,2.086 and 2.145,respectively,all P 0.05）.The incidences of rebleeding and DIC and the rate of hysterectomy of patients in the observation group were all significantly lower than those of patients in the control group（χ~2 value was 4.617,5.024 and 4.849,respectively,all P 0.05）.The total incidence of adverse reactions in observation group was significantly lower than that in the control group（χ~2=4.876,P0.05）.Conclusion Uterine packing combined with water sac compression hemostasis is of significant hemostatic effect in the treatment of pernicious placenta previa with lower rebleeding and DIC incidence and lower hysterectomy rate.
出处
《中国妇幼健康研究》
2018年第2期224-226,共3页
Chinese Journal of Woman and Child Health Research
关键词
宫腔填塞
水囊压迫止血
凶险型前置胎盘
止血效果
uterine packing
water sac compression hemostasis
pernicious placenta previa
hemostatic effect
