宫颈环扎术加球囊压迫宫腔在难治性产后出血中的应用

目的探讨宫颈环扎术加球囊压迫宫腔在难治性产后出血中的临床疗效价值。方法选择2005年2月15日～2009年10月10日收治的难治性产后出血患者40例,所有患者均药物治疗效果不佳,且处于休克状态不能控制出血时,按照止血方式的不同,随机分为观察组和对照组各20例。观察组20例采用宫颈环扎术加球囊压迫宫腔的方法治疗难治性产后出血;对照组20例则行子宫切除术治疗难治性产后出血。并比较两组的手术时间、住院时间、有效率等临床上止血方法的效果。结果观察组20例采用宫颈环扎术加球囊压迫宫腔止血方法治疗的难治性产后出血,止血有效率为100%,术后子宫复旧好,保留了子宫及其生理功能,无严重的并发症发生;对照组20例采用常规性子宫切除术止血的有效率为100%。两组止血效果比较差异无统计意义(P>0.05);两组手术时间、住院时间等比较有统计学意义(P<0.05)。结论宫颈环扎术加球囊压迫宫腔止血法简单易行,止血迅速可靠效果好,保留了患者子宫和生育功能,可替代子宫切除术,有显著的优点及临床实用价值,值得在基层医院推广。

The Application of Cervical Cerclage with Intrauterine Balloon Pressure in Intractable Postpartum Hemorrhage

Objective To discuss the value clinical efficacy of the cervical cerclage with intrauterine balloon pressure in intractable postpartum hemorrhage. Methods Selecting 40 cases with intractable postpartum hemorrhage from February 15, 2005 to October 10, 2009, all the patients, who were ineffective with drug therapy and were in a state of shock beyond the control of bleeding, were randomly divided into two groups according to the different ways to stop bleeding. In the observation group, 20 patients treated with cervical cerclage and intrauterine balloon compression method for refractory postpartum hemorrhage; in the control group, 20 patients were treated with hysterectomy for refractory postpartum hemorrhage, to compare the two groups in operative time, hospitalization time, and efficient methods such as clinical hemostatic effect. Results In the observation group, 20 patients treated with cervical cerclage and balloon compression method of uterine bleeding for refractory postpartum hemorrhage, had the hemostasis rate of 100%, good postoperative uterine involution, retained uterus and the physiological function, no severe complications occurred; in control group, 20 patients treated with conventional hysterectomy, had the hemostasis rate of 100%. In the two groups, hemostatic effects had no statistically significance (P >0.05), but operative time, hospitalization time had statistically significance (P <0.05). Conclusion Cervical cerclage with intrauterine balloon pressure hemostasis is simple, fast and reliable with good hemostasis effect, retaining the uterus and reproductive function of patients, and can replace hysterectomythere, which has significant advantages and practical value, and deserves promotion in local hospitals.