摘要
目的分析止血带联合子宫下段提拉式缝合在胎盘植入性疾病中的应用效果。方法回顾性分析76例术中确诊为胎盘植入性疾病患者的临床资料,根据术中胎盘处理方法不同分为对照组和观察组,每组38例。对照组使用常规胎盘处理及子宫内压迫止血,观察组使用止血带联合子宫下段提拉式缝合进行胎盘处理。对比两组的手术相关指标、术后并发症发生率、生活质量评分、子宫切除及输血情况。结果观察组手术时间(92.13±12.60)min、住院时间(8.44±1.56)d、术中出血量(1023.52±126.43)ml、产后24 h累计出血量(1130.43±130.74)ml、修正血红蛋白(Hb)值(82.14±9.60)g/L均明显优于对照组的(108.34±11.42)min、(10.62±1.88)d、(1402.82±170.53)ml、(1524.87±189.62)ml、(68.53±8.96)g/L,差异均有统计学意义(P<0.05)。观察组子宫切除率5.26%低于对照组的21.05%,差异有统计学意义(P<0.05)。观察组红细胞输注率89.47%、平均红细胞输注量(645.24±56.13)ml明显低于对照组的100.00%、(794.75±75.34)ml,差异均有统计学意义(P<0.05)。观察组术后并发症发生率7.89%明显低于对照组的26.32%,差异具有统计学意义(P<0.05)。观察组精神健康、情感职能、社会功能、生理职能评分分别为(86.22±8.35)、(88.09±7.34)、(87.24±6.64)、(85.34±7.41)分,明显高于对照组的(80.58±8.77)、(82.38±7.44)、(82.38±6.77)、(80.08±7.75)分,差异均有统计学意义(P<0.05)。结论对胎盘植入性疾病患者采用止血带联合子宫下段提拉式缝合处理能取得较好的止血效果,减少出血量,更好地保留患者的子宫及生育能力,从而提升其生活质量。
Objective To analyze the application effect of tourniquet combined with lower uterine segment lifting suture in patients with placenta accrete spectrum disorders.Methods The clinical data of 76 patients diagnosed with placenta accrete spectrum disorders during operation were retrospectively analyzed,and they were divided into a control group and an observation group according to different methods of placental processing during operation,with 38 cases in each group.The control group was treated with routine placental processing and intrauterine compression hemostasis,and the observation group was treated with tourniquet combined with lower uterine segment lifting suture.The surgery-related indicators,incidence of postoperative complications,quality of life score,hysterectomy and blood transfusion of the two groups was compared.Results In the observation group,the operation time was(92.13±12.60)min,the hospitalization time was(8.44±1.56)d,the intraoperative blood loss was(1023.52±126.43)ml,and the cumulative blood loss within 24 h after delivery was(1130.43±130.74)ml,and the corrected hemoglobin(Hb)was(82.14±9.60)g/L,which were significantly better than(108.34±11.42)min,(10.62±1.88)d,(1402.82±170.53)ml,(1524.87±189.62)ml,and(68.53±8.96)g/L in the control group.The difference was statistically significant(P<0.05).The rate of hysterectomy was 5.26%in the observation group,which was lower than 21.05%in the control group,and the difference was statistically significant(P<0.05).In the observation group,the average volume of red blood cell transfusion were 89.47%and(645.24±56.13)ml,which were significantly lower than 100.00%and(794.75±75.34)ml in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 7.89%,which was significantly lower than 26.32%in the control group,and the difference was statistically significant(P<0.05).The scores of mental health,emotional function,social function and physiological function in th
作者
李传征
钱俊如
LI Chuan-zheng;QIAN Jun-ru(Department of Obstetrics and Gynecology,Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital,Xuzhou 221000,China)
出处
《中国实用医药》
2024年第7期75-78,共4页
China Practical Medicine
关键词
胎盘植入性疾病
止血带
子宫下段提拉式缝合
出血量
Placenta accrete spectrum disorders
Tourniquet
Lower uterine segment lifting suture
Blood loss
