两种宫腔填塞方法在产后出血中的临床应用效果分析

摘要

Objective:To investigate the clinical effect of using different uterine packing hemostatic methods to treat postpartum hemorrhage undergoing vaginal delivery. Method:50 patients with postpartum hemorrhage caused by uterine inertia and undergone vaginal delivery in two hours were analyzed retrospectly in the hospital from June 2007 to June 2012. They were divided into the study group(uterine hyponome packing + vagina gauze packing group n=25)and the control group(uterine packing group n=25).The operative time,the hemostatic time,the hemostatic effective time, the wadding indwelled time,the puerperal rate,the wadding failure rate,and the hysterectomy cases were observed in the two groups. Result:The wadding implanted time,the wadding indwelled time and the hemostatic effective time in the study group decurtated significantly and the hemostatic effect improved remarkably. There were significant difference between the two groups(P< 0.05). The wadding failure rate in the control group was higher and was significant difference between the two groups(P<0.05). The hysterectomy rate and the puerperal infection in the control group were higher and no significant difference between the two groups(P>0.05). Conclusion:The method of uterine hyponome packing and virginal gauze packing is easy to draw the materials and operate and the treatment is positive. These methods apply to the patients with postpartum hemorrhage caused by uterine inertia in earlier period undergoing vaginal delivery in basic hospitals.%　　目的：探讨采用不同的宫腔填塞止血方法治疗阴道分娩产后出血的临床效果。方法：回顾分析2007年6月-2012年6月在本院阴道分娩后2 h 内，出现宫缩乏力性产后出血患者50例，分为研究组（腔水囊填塞+阴道纱条填塞组）和对照组（宫腔填纱组）各25例，观察两组手术操作时间、止血时间、止血显效时间、填塞物留置体内时间、产褥病率、填塞失败率、子宫切除例数等。结果：研究组的填塞物置入时间、填塞物留置时间、止血显效时间明显缩短，止血有效率明显提高，与对照组比较差异有统计学意义（P<0.05），研究组的填塞失败率明显低于对照组（P<0.05），两组子宫切除率及产褥病率差异无统计学意义（P>0.05）。结论：宫腔水囊填塞+阴道填纱治疗产后出血方法取材方便，操作简单，疗效肯定，比较适用于基层医院阴道分娩产后早期子宫收缩乏力所致的产后出血者。