纱条填塞宫腔止血在前置胎盘剖宫产术中出血的应用

目的观察并评价前置胎盘剖宫产术中出血应用纱条填塞宫腔止血的临床价值。方法选取2009至2011年间在我院实行前置胎盘剖宫产术且术中出血伴随止血困难的患者60例,将其随机分为实验组(A组)和对照组(B组),每组患者30例。A组患者给予纱条填塞宫腔法予以止血,随后立即对其子宫切口进行缝合;B组患者注射缩宫素,大纱布压迫出血处或者缝合出血点,并结合止血药物等传统方式进行处理。比较两组患者的术中平均出血量和术后的住院时间,切口的愈合程度,术后的阴道出血量等指标。结果 A组患者的术中平均出血量为(534.5±48.1)mL显著少于B组的(833.5±67.2)mL,差异有统计学意义(P<0.05)。在术后各指标的对比中,A组的住院时间和及切口的甲级愈合率与B组无明显的统计学差异(P>0.05),但是A组的术后阴道出血量(93.7±11.3)mL要显著低于B组(155.6±14.7)mL,差异具有统计学意义(P<0.05)。结论前置胎盘剖宫产术中出血应用纱条填塞宫腔止血临床效果显著,有利于患者的预后,值得临床推广。

Clinical Analysis of Intrauterine Ribbon Gauze Packing for Hemostasis in the Treatment of Bleeding in Placenta Previa Caesarean Section Operation

Objective To observe and evaluate the clinical value of intrauterine ribbon gauze packing for hemostasis in bleeding of placenta previa caesarean section operation. Methods Sixty patients with bleeding and difficult hemostasis during placenta previa cesarean section in our hospital from 2009 to 2011 were chosen and randomly divided into two groups with 30 cases in each group. The experimental group （group A） had intrauterine ribbon gauze packing for hemostasis, then the uterine incision was sutured immediately; the control group （group B） received the traditional method for hemostasis such as oxytocin for injection, pledgeted compression or suture of petechiae. The mean bleeding volum, postoperative hospital stay time, healing degree of incision and vaginal blood loss in the two groups were compared. Results The mean intraoperatve bleeding volum of group A was （534.5 ± 48.1） mL, significantly fewer than group B [833.5 ± 67.2） mL]; the difference was statistically significant （P 〈0.05）. The difference of hospital stay time and incision class A healing rate between group A and group B was not statistically significant （P 〉0.05）. The postoperative vaginal bleeding amount of group A [（93.7 ± 11.3） mL] was lower than that of group B [（155.6 ± 14.7） mL], and the difference was statistically significant （P 〈0.05）. Conclusions The clinical effect of intrauterine ribbon gauze packing for hemostasis in bleeding of placenta previa caesarean section operation is significant and benefit to patients＇ prognosis, which is worthy of clinical application.