宫腔纱条填塞用于剖宫产出血50例效果观察

目的：观察宫腔纱条填塞法用于剖宫产出血的效果。方法：取剖宫产出血：100例，随机取50例为实验组，50例为对照组，两组病情分布相同。在常规注射缩宫素后，宫腔出血仍来势迅猛者，实验组立即行宫腔纱条填塞，缝合子宫切口，术后给高效抗菌素预防感染，24～48小时取出纱条。对照组给麦角0．2mg子宫下段注射，或米索前列醇0．2mg置后穹隆，经子宫按摩、热盐水大纱块压迫等处理效果不佳者，即行双侧子宫动脉结扎。结果：实验组50例，术中出血均在300～500ml，平480．20ml，明显低于文献报道前置胎盘术中出血平均768.01ml，与无高危因素的正常剖宫产平均出血414．15ml差异不大，未发生术后感染现象。无一例子宫切除，达到保留子宫目的。对照组术中出血500ml以下为0，500～700ml 20例，800～1700ml 30例，术中出血量明显高于实验组，差异极具显著性。其中1例出血达1700ml，输同型血1000ml，最终以宫腔纱条填塞止血。结论：宫腔纱条填塞止血迅速，效果好，并达到保留子宫目的，无明显副作用。宫腔纱条填塞方法容易，材料制作简单，价格不昂贵。宫腔纱条填塞是治疗剖宫产出血的最好方法。

An Observation of the Effect of Intrauterine Packing with Ribbon Gauze for Hemostasis in Cesarean Section in 50 Cases

Objective:This paper is to observe the effect of intrauterine packing with ribbon gauze for hemostasis in cesarean section 50 cases.Method:A free sampling of 50 cases from 100 cases of abdominal delivery was used to make an experimental group,and the rest 50 cases were used as the control.The two groups had the same symptom.Hysterotonics was injected as usual,then ribbon gauze was applied to those in the experimental group with much hemorrhage in uterine cavity and the incision was sutured.After the operation hypereffective antibiotic was administered to prevent infection.The gauze was taken out 24 to 48 hours later.In the control group,only 0 2mg of ergota was injected into the lower uterus,or 0 2mg of fluprostenol was applied to posterior fornix.Then uterus massage and hot saline gauze pressing were applied.When all these failed,bilateral uterine artery ligation was applied immediately.Results:The hemorrhage in the experimental group varied from 300 to 500ml,with an average of 480 20ml,which was siginficantly lower than 768 01ml,the average hemorrhage in placental presentation as reported in other documents,and was very close to the average of 414 15ml hemorrhage in normal abdominal delivery without high risk factors.Moreover,no infection occurred after the operation,and not a single case of the uterus was removed.While in control group the hemorrhage ranged from 500 to 1700ml,with significant higher hemorrhage than that in the experimental group.In one case the hemorrhage was as much as 1700ml,and 1000ml of blood was given,and at the end we had to use intrauterine packing with ribbon gauze for hemostasis.Conclusion:Intrauterine packing with ribbon gauze for hemostasis can stop bleeding quickly with good effect,and the uterus was protected without discernable side effect.Intrauterine packing with ribbon gauze for hemostasie was easy to practice,and the material was easy to get at low price.Thus intrauterine packing with ribbon gauze for hemostasis was the best way to deal with hemorrhage in cesarean section.