子宫交叉捆绑缝合术对剖宫产术中难治性产后出血的疗效分析

摘要

Objective To investigate the efficacy and safety of cross binding suture for intractable postpartum hemorrhage during cesarean section.Method A total of 64 patients with intractable postpartum hemorrhage during cesarean delivery treated in the department of obstetrics of the Second People's Hospital of Shunde and Shunde Hospital of Southern Medical University during January 2015 and March 2017 were selected as study objects,and they were divided into study group(n=40)and control group (n=24)randomly.The patients in the study group were treated with cross binding suture while those in the control group were treated with B-lynch suture.The hemostatic efficiency,intraoperative bleeding volume,bleeding volume 2 hours and 24 hours after operation,average hospitalization time,and postoperative complications in two group were compared.Results The hemostatic efficiency in the study group was 97.50%,which was significantly higher than 83.33% in the control group(χ2=4.180,P<0.05). The intraoperative bleeding volume,bleeding volume 2 hours and 24 hours after operation of patients in the study group were significantly lower than those in the control group(t value was 4.497,4.749 and 5.425,respectively,all P<0.05).The average hospitalization time of patients in the control group was 6.32 ± 0.81days,which was significantly longer than that(5.60 ± 0.70 days)in the study group(t=3.670,P<0.05).There was no postoperative complication found in the study group,while in the control group,there was 1 case of intrauterine adhesions and 1 case of myometrial necrosis.Conclusion The cross binding suture is an effective and novel method for the treatment of intractable postpartum haemorrhage,which is of few complications and worthy of clinical application.%目的 探讨子宫交叉捆绑缝合术对剖宫产术中难治性产后出血的疗效与安全性.方法 选择2015年1月至2017年3月,广东省佛山市顺德区第二人民医院和南方医科大学顺德医院产科收治的64例剖宫产术中难治性产后出血患者作为研究对象,随机分为研究组(40例)与对照组(24例).研究组采用子宫交叉捆绑缝合术治疗,对照组采用B-Lynch缝合术治疗.比较两组患者的止血有效率,术中、术后2h及术后24h的出血量,平均住院天数及术后并发症.结果 研究组止血有效率为97.50%,显著高于对照组的83.33%(χ2=4.180,P<0.05);研究组术中、术后2h及术后24h的出血量均显著低于对照组(t值分别为4.497、4.749、5.425,均 P<0.05);对照组平均住院天数为(6.32 ± 0.81)天,显著高于研究组(5.60 ± 0.70)天(t=3.670,P<0.05);研究组术后未发现并发症,对照组有宫腔粘连和子宫肌层坏死各1例.结论 子宫交叉捆绑缝合术是一种新型的、有效的难治性产后出血治疗方法,其并发症少,值得临床推广应用.