宫腔水囊压迫治疗产后出血的对比性研究

目的:探讨宫腔水囊压迫治疗产后出血较宫腔纱条填塞治疗产后出血的优越性。方法:选择产后出血患者66例作为研究对象,经常规处理后仍有阴道大量出血或有大出血倾向,按不同治疗方法随机分为水囊组34例,行宫腔水囊压迫止血;纱条组32例,行宫腔纱条填塞止血。比较2组显效时间、操作所需时间、留置时间;治疗后阴道出血量、取出过程阴道出血量、取出后阴道出血量、操作引起软产道裂伤、子宫复旧情况、再次出血发生率、子宫切除率、感染率、死亡率、住院时间。结果:水囊组显效时间(309.06±39.75)s,纱条组(286.47±60.34)s,两组比较差异无统计学意义(t=1.823,P=0.073);水囊组操作时间平均值(147.56±21.75)s,纱条组(416.76±75.06)s,两组比较差异有统计学意义(t=-20.08,P=0.000);水囊组留置时间平均值(16.82±3.48)h,纱条组(25.91±2.19)h,两组比较差异有统计学意义(t=-10.498,P=0.000);水囊组与纱条组放置后2 h、12 h出血量,两组比较差异无统计学意义(P>0.05);水囊组与纱条组取出过程出血量,两组比较差异无统计学意义(P>0.05);水囊组与纱条组取出后2 h、12 h、24 h、48 h出血量比较,两组比较差异无统计学意义(P>0.05);水囊组与纱条组住院时间比较,两组比较差异有统计学意义(P<0.05);水囊组与纱条组操作引起软产道裂伤、再次出血发生率、子宫切除率、感染率、死亡率比较,两组比较差异无统计学意义。结论:宫腔水囊压迫治疗产后出血优于宫腔纱条填塞治疗产后出血。

Comparative study on uterine water sac compression for treatment of postpartum hemorrhage

Objective:To explore the superiority of uterine water sac compression for treatment of postpartum hemorrhage compared with intrauterine gauze packing.Methods:A total of 46 patients with postpartum hemorrhage were selected as study objects,after routine treatment,there was still massive vaginal bleeding or the trend of massive vaginal bleeding;and then the patients were randomly divided into uterine water sac group compression group(34 patients treated with uterine water sac compression) and intrauterine gauze packing group(32 patients treated with intrauterine gauze packing).The effective times,operation times,and retention times,amounts of postoperative vaginal bleeding,amounts of vaginal bleeding during removal,amounts of vaginal bleeding after removal,incidence rates of laceration of soft birth canal,involution of uterus,rebleeding,hysterectomy,infection,mortality,and hospitalization times in the two groups were compared.Results:The effective rates in uterine water sac group compression group and intrauterine gauze packing group were(309.06±39.75) seconds and(286.47±60.34) seconds,respectively,there was no statistically significant difference between the two groups(t=1.823,P=0.073);the mean operation times in uterine water sac group compression group and intrauterine gauze packing group were(147.56±21.75) seconds and(416.76±75.06) seconds,respectively,there was statistically significant difference between the two groups(t=-20.08,P=0.000);the mean retention times in uterine water sac group compression group and intrauterine gauze packing group were(16.82±3.48) hours and(25.91±2.19) hours,respectively,there was statistically significant difference between the two groups(t=-10.498,P=0.000);there was no statistically significant difference in amounts of vaginal bleeding at 2 and 12 hours after treatment between the two groups(P>0.05);there was statistically significant difference in amount of vaginal bleeding during removal between the two groups(P>0.05);there was no statistically significant difference in amount of vaginal bleeding at 2,12,24,and 48 hours after removal between the two groups(P>0.05);there was statistically significant difference in hospitalization time between the two groups(P<0.05);there was no statistically significant difference in incidence rates of laceration of soft birth canal,rebleeding,hysterectomy,infection,and mortality between the two groups.Conclusion:The curative effect of uterine water sac compression for treatment of postpartum hemorrhage is better than intrauterine gauze packing.