自制水囊宫腔填塞治疗未临产剖宫产术后产后出血的疗效观察

目的探讨自制水囊宫腔压迫治疗未临产剖宫产术后产后出血的疗效。方法选择未临产（宫口开0-3 cm）剖宫产术中及产后出血病例52例,将自制水囊送入宫底部,注入37℃-40℃生理盐水至宫腔不出血为止,24 h后取出,分析操作时间、显效时间、填塞物留置时间、住院时间、术中出血量、术后2 h出血量、术后12 h出血量、取出过程出血量、取出后24 h出血量和取出后48 h出血量和术后感染发生率。结果自制水囊压迫宫腔止血法均能有效的止血,留置时间15-18 h,取出水囊后宫缩恢复良好,阴道流血量较少;24 h-10 d内,每日测体温4次,有9例体温达38℃-38.5℃,经常规给予抗生素后体温恢复正常。结论自制水囊压迫治疗未临产剖宫产术中、剖宫产术后产后出血,尤其对剖宫产术后宫口未开或宫口开0-3 cm术中未放置宫腔纱条又没得到有效救治时,均能有效防治产后出血,值得在基层医院推广。

Effect of the self-made water sac on caesarean section not in labor or postpartum hemorrhage

Objective To evaluate the effect of the self-made water sac on caesarean section not in labor or postpartum hemorrhage. Methods Chose 52 cases not in labor（Palace mouth open 0-3 cm） of cesarean section and postpartum hemorrhage, put the water pocket into the palace at the bottom, inject 37℃-40℃ physiological saline to the uterine cavity until the bleeding stopping, and remove the water pocket after 24 hours, Operation time, action time,stuffing the indwelling time, hospitalization, bleeding volume（including intraoperation, 2 h and 12 h after operation, remove the process and 24 h and 48 h after the removation） and the incidence of postoperative infection were analysised.Results Self-made water sac compression uterine cavity haemostasis effective hemostatic, indwelling time 15 to 18hours, take out the water sac harem recovered well, less the amount of vaginal bleeding; within 10 days after 24hours-measuring temperature 4 times a day, there were 9 cases of temperature of 38℃- 38.5℃, after conventional given antibiotics, body temperature returned to normal. Conclusion The self-made water sac was the fast, safe, reliable, economic treatment, which can effectively prevent postpartum hemorrhage. Especially suitable for the cervix was not open or open 0-3cm after caesarean section, and not placed intrauterine ribbon gauze during the surgery. It is worth popularizing in primary hospitals.