摘要
目的:探讨子宫下段连续环形缩窄缝合术在剖宫产术中出血中的应用。方法:对2016年3月至2019年10月我院收治41例剖宫产术后子宫下段胎盘剥离面活动性出血产妇行子宫下段连续环形缩窄缝合术。观察子宫切除例数,术中出血量,术后2 h、2-24 h出血量,输血产妇例数。术后2 d检查血红蛋白和红细胞计数水平。结果:本组41例剖宫产术中出血产妇经子宫下段连续环形缩窄缝合术治疗后,术中、术后出血均得到有效控制。1例(2.4%)切除子宫,20例(48.8%)加用双侧子宫动脉上行支结扎术,2例(4.8%)联合采用宫腔纱布填塞术。术中平均出血量862 ml,产后2 h平均出血量39.5 ml,产后2-24 h平均出血量为110.9 ml。17例输血,输血率41.46%。术后2 d血红蛋白水平为97.8±23.5 g·L^(-1),红细胞计数为(3.4±1.5)×10^(12)·L^(-1)。产后未见并发症。结论:子宫下段连续环形缩窄缝合在剖宫产术中的止血效果理想,操作方法简单、迅速,有助于保留产妇子宫和生育功能,值得临床推广应用。
Objective:To explore the application of continuous circular constriction suture of the lower uterine segment in the bleeding of cesarean section.Methods:From March 2016 to October 2019,Forty-one cases of active hemorrhage of placenta detachment surface in the lower segment were treated by continuous circular constriction suture of the lower uterine segment.The number of hysterectomies,bleeding amount during operation and 2 h,2-24 h after operation,blood transfusion were recorded.The hemoglobin and red blood cell were measured 2 days after operation.Results:After continuous circular constriction suture of the lower segment,bleeding was effectively controlled during and after operation.1 case(2.4%)underwent hysterectomy,20 cases(48.8%)received ligation of the ascending branches of the bilateral uterine arteries,and 2 cases(4.8%)received intrauterine gauze packing.Average amount of bleeding was 862 ml in operation,39.5 ml in 2 h and 110.9 ml in 2-24 h.The hemoglobin was 97.8±23.g·L-1 and the RBC count was(3.4±1.5)×1012/L,2 days after operation.No complications were found after delivery.Conclusion:The hemostasis effect of continuous circular constriction suture of the lower segment in cesarean section is ideal.
作者
张波
姚丽凤
王玉
刘爱民
Zhang Bo;Yao Feng-li;Wang Yu;Liu Ai-min(Department of Obstetrics,Pingxiang Maternity and Child Health Care Hospital,Pingxiang 337000,Jiangxi,China)
出处
《四川生理科学杂志》
2020年第3期314-317,共4页
Sichuan Journal of Physiological Sciences
关键词
子宫下段连续环形缩窄缝合
剖宫产术
术中出血
Continuous circular constriction suture of the lower uterine segment
Cesarean section
Intraoperative bleeding
