子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血的临床研究(1)
摘 要：目的 研究子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血的临床效果。方法 回顾分析2017年1月～12月在我院治疗的70例前置胎盘剖宫产术中胎盘剥离面出血患者，将其随机分为对照组和观察组，每组35例。对照组采用传统的“8”字缝合方法止血，观察组采用子宫下段横形环状压迫缝合术止血，观察对比两组术中出血量、术后出血量、欣母沛使用量、缩宫素使用量和并发症发生率。结果 观察组术中出血量、术后出血量、欣母沛使用量少于对照组，差异有统计学意义(P<0.05)；两组缩宫素使用量、并发症发生率相比，差异均无统计学意义(P>0.05)。结论 子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血安全有效，值得临床推广和应用。
关键词：压迫缝合术；前置胎盘；剖宫产；胎盘剥离面出血
中图分类号：R719.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.040
, http://www.100md.com
文章编号：1006-1959(2018)07-0120-02
Clinical Study on the Treatment of Placental Exfoliation Bleeding in Caesarean Section of Placenta Previa by Transverse Annular Compression Suture of Lower Uterine Segment
JIANG Hong-mei
(Department of Obstetrics and Gynecology，Two Subjects，Jiamusi Central Hospital，Jiamusi 154002，Heilongjiang，China)
Abstract：Objective To study the clinical effect of transversal annular compression suture in the treatment of placental hemorrhage in placenta previa during caesarean section.Methods A retrospective analysis of 70 cases of placenta previa hemorrhage during caesarean section in our hospital from January to December 2017 was performed.The patients were randomly divided into control group and observation group with 35 cases in each group.The control group was hemostatic by traditional "8" suture method，and the observation group was treated with transverse annular suture of the lower segment of uterus.The amount of blood loss during operation， the amount of bleeding after operation，and the amount of blood used by Hemabate were observed and compared between the two groups.Oxytocin usage and incidence of complications.Results In the observation group， the amount of bleeding，bleeding volume and the amount of Hemabate in the observation group were less than those in the control group.The difference was statistically significant (P<0.05).There was no significant difference in the amount of oxytocin and the incidence of complications between the two groups(P> 0.05).Conclusion Transverse annular suture of the lower uterine segment is safe and effective in the treatment of placenta previa during cesarean section，which is worth popularizing and applying in clinic.
, 百拇医药
Key words：Compression suture；Placenta previa；Cesarean section；Placental dissecting hemorrhage
前置胎盤(placenta previa)是产科的常见并发症，剖宫产终止妊娠是临床治疗前置胎盘的主要手段。前置胎盘剖宫产术中胎盘剥离面出血是临床治疗的难点[1]。由于胎盘剥离面收缩性差，血窦不容易闭合，特别是中央性前置胎盘剖宫产术中容易发生出血，且止血难度大，严重威胁产妇和胎儿的生命安全，是临床急症切除子宫的指征之一[2]。所以，临床有效的止血方法是关键，可避免子宫切除，提高剖宫产术的安全性。本文作者结合2017年1月～12月在我院治疗的70例临床资料，观察子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血的临床效果，现报告如下。, http://www.100md.com(蒋红梅)
关键词：压迫缝合术；前置胎盘；剖宫产；胎盘剥离面出血
中图分类号：R719.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.040
, http://www.100md.com
文章编号：1006-1959(2018)07-0120-02
Clinical Study on the Treatment of Placental Exfoliation Bleeding in Caesarean Section of Placenta Previa by Transverse Annular Compression Suture of Lower Uterine Segment
JIANG Hong-mei
(Department of Obstetrics and Gynecology，Two Subjects，Jiamusi Central Hospital，Jiamusi 154002，Heilongjiang，China)
Abstract：Objective To study the clinical effect of transversal annular compression suture in the treatment of placental hemorrhage in placenta previa during caesarean section.Methods A retrospective analysis of 70 cases of placenta previa hemorrhage during caesarean section in our hospital from January to December 2017 was performed.The patients were randomly divided into control group and observation group with 35 cases in each group.The control group was hemostatic by traditional "8" suture method，and the observation group was treated with transverse annular suture of the lower segment of uterus.The amount of blood loss during operation， the amount of bleeding after operation，and the amount of blood used by Hemabate were observed and compared between the two groups.Oxytocin usage and incidence of complications.Results In the observation group， the amount of bleeding，bleeding volume and the amount of Hemabate in the observation group were less than those in the control group.The difference was statistically significant (P<0.05).There was no significant difference in the amount of oxytocin and the incidence of complications between the two groups(P> 0.05).Conclusion Transverse annular suture of the lower uterine segment is safe and effective in the treatment of placenta previa during cesarean section，which is worth popularizing and applying in clinic.
, 百拇医药
Key words：Compression suture；Placenta previa；Cesarean section；Placental dissecting hemorrhage
前置胎盤(placenta previa)是产科的常见并发症，剖宫产终止妊娠是临床治疗前置胎盘的主要手段。前置胎盘剖宫产术中胎盘剥离面出血是临床治疗的难点[1]。由于胎盘剥离面收缩性差，血窦不容易闭合，特别是中央性前置胎盘剖宫产术中容易发生出血，且止血难度大，严重威胁产妇和胎儿的生命安全，是临床急症切除子宫的指征之一[2]。所以，临床有效的止血方法是关键，可避免子宫切除，提高剖宫产术的安全性。本文作者结合2017年1月～12月在我院治疗的70例临床资料，观察子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血的临床效果，现报告如下。, http://www.100md.com(蒋红梅)