筋膜内子宫动脉分段结扎联合纱条填塞于前置胎盘剖宫产中的应用

摘要

Objective To analyze the application of segmental ligation of uterine artery inside the fascia of combined with gauze packing in placenta previa cesarean section.Methods 60 patients of cesarean section in placenta previa bleeding,were randomly divided into observation group and control group,30 cases in each group. The observation group were treated with intrafascial uterine artery segment ligation combined with gauze with the traditional method,the control group were treated with ligation of bilateral uterine artery and uterine segment multi-point injection of hemabate. The intraoperative bleeding 24h,postoperative blood transfusion rate,menstrual recovery time after surgery were compared and analyzed.Results The observation group of patients with the same type of patients with intraoperative blood loss and postoperative bleeding 24h were significantly less than control group(P<0.05),uterine resection rate(3.3%)in the observation group was significantly lower than the control group (20%)(P<0.05),blood transfusion rate(20%) in the observation group was significantly less than the control group(52.2%)(P<0.05), patients in the observation group had a shorter hospitalization time(3.4±1.5)d than control group(5.6±2.7)d(P<0.05),there were no significant difference(P>0.05)on the duration of lochia,first time menstruation recovery time,postpartum menstrual cycle between the observation group and the control group.Conclusions In placenta previa cesarean section, thesegmental ligation of uterine artery inside the fascia of combined with gauze packing can effectively reduce the operative and postoperative bleeding,shorten the hospitalization time,reduce complications.%目的：分析筋膜内子宫动脉分段结扎联合纱条填塞于前置胎盘剖宫产中的应用。方法选取前置胎盘剖宫产术中出血患者60例，随机分为观察组和对照组，每组各30例。观察组患者采取筋膜内子宫动脉分段结扎联合纱条填塞，对照组患者给予传统法结扎双侧子宫动脉及子宫下段多点注射欣母沛，分析术中、术后24h出血量、输血率、术后月经恢复时间等。结果观察组患者相同类型患者术中出血量和术后24h出血量均少于对照组（P<0.05），观察组患者子宫切除率（3.3％）低于对照组（20.0％）（P<0.05），观察组患者输血率（20.0％）小于对照组（52.2％）（P<0.05），观察组患者住院时间（3.4±1.5）d短于对照组（5.6±2.7）d（P<0.05），观察组患者恶露持续时间、第一次月经恢复时间、产后月经周期等与对照组差异无统计学意义（P>0.05）。结论在前置胎盘剖宫产中，采用筋膜内子宫动脉分段结扎联合纱条填塞能够有效减少术中和术后出血量，缩短住院时间，降低并发症发生，具有推广价值。