子宫动脉结扎联合宫腔纱布填塞术治疗难治性产后大出血的效果观察

目的:观察子宫动脉结扎联合宫腔纱布填塞治疗难治性产后出血的效果.方法:选择剖宫产术中大出血患者39例,其中行子宫动脉结扎及改良B-lynch缝合的18例为对照组,行子宫动脉结扎联合宫腔纱布填塞术的21例为观察组.观察2组手术时间、手术效果及并发症发生情况.结果:观察组21例均成功止血并保留了子宫;对照组18例中16例保留子宫,2例因止血不满意行子宫切除术.观察组24 h出血量少于对照组(P<0.01);观察组子宫切除数、手术时间和产褥病与对照组差异均无统计学意义(P>0.05).结论:子宫动脉结扎联合宫腔纱布填塞术对难治性产后出血疗效可靠,简单易行,减少了术中出血量,保留了子宫,无并发症及不良反应.

The effects of treatment for refractory postpartum hemorrhage with uterine artery ligation combined with gauze packing in the uterine cavity

Objective:To investigate the effects of treatment for refractory postpartum hemorrhage with uterine artery ligation combined with gauze packing in the uterine cavity.Methods:Thirty-nine patients with refractory postpartum hemorrhage during cesarean section were divided into the control group which were treated with the uterine artery ligation combined with modified B-lynch suture(18 cases) and the observation group which were treated with the uterine artery ligation combined with gauze packing in the uterine cavity(21 cases).The methods,indications,time,results and complications of operation of two groups were observed.Results:Twenty-one patients of the observation group were successfully treated,and their uteruses were retained.The 16 patients′ uteruses of the control group were retained except 2 patients with the poor hemostatic effect.The amount of hemorrhage in 24 hours in the observation group was less than that in the control group(P<0.01).But there were no significant differences between the two groups about hysterectomy numbers,operation time and puerperal morbidity.Conclusions:The effects of treatment for refractory postpartum hemorrhage with uterine artery ligation combined with gauze packing in the uterine cavity is good.The cure is simple and feasible,less bleeding,no complications and adverse effects and can retain uterus.