摘要
目的探讨完全性前置胎盘(complete placenta previa,CPP)产妇剖宫产术中不同止血方案的应用及效果,旨在为临床合理应用提供依据。方法选择2016年1月至2019年1月行剖宫产分娩的CPP产妇90例,依据止血方式不同分为观察1、2、3组,3组术中分别采用子宫颈环扎术、BLynch缝合+水囊及局部缝合+水囊止血,对比3组产妇术中出血量、手术时间、术中输液量、子宫切除率、手术前后血红蛋白(hemoglobin,Hb)水平及术后并发症发生情况。结果观察1组产妇术中出血量、手术时间、术中输液量及手术前后Hb差值均低于观察2、3组,差异有统计学意义(P<0.05);观察2、3组间术中出血量、手术时间、术中输液量及手术前后Hb差值差异无统计学意义(P>0.05);观察1组子宫切除率、产后出血发生率低于观察2组和观察3组,差异有统计学意义(P<0.05),3组间弥散性血管内凝血(DIC)及多器官功能障碍综合征(MODS)发生率差异无统计学意义(P>0.05)。结论CPP产妇剖宫产术中应用子宫颈环扎术进行止血效果可靠,值得临床推广使用。
Objective To investigate the application effects of different hemostasis schemes in puerpera with complete placenta previa(CPP)undergoing cesarean section in order to provide an evidence for the clinically rational application.Methods The puerpera with CPP who undrwent cesarean section in our hospital from January 2016 to January 2019 were enrolled in the study,who were dvided into observation group 1,observation group 2,observation group 3 according to different hemostasis schemes.The patients in the three groups were given cervical ligation during operation,with BLynch suture+water sac and local suture+water sac hemostasis.The intraoperative bleeding volume,operation time,intraoperative transfusion volume,hysterectomy rate,the changes of Hb levels before and after operation,and postoperative complications were observed and compared among the three groups.Results The intraoperative bleeding volume,operation time,intraoperative transfusion volume,and the Hb levels before and after operation in observation group 1 were significantly lower than those in observation group 2 and those in observation group 3(P<0.05).However there were no significant differences in the intraoperative bleeding volume,operation time,intraoperative transfusion volume,the Hb levels before and after operation between observation group 2 and observation group 3(P>0.05).Moreover the hysterectomy rate and the incidence rate of postpartum hemorrhage in observation group 1 were significantly lower than those in observation group 2 and those in observation group 3(P<0.05),however there were no significant differences in the incidence rates of DIC and MODS among the three groups(P>0.05).Conclusion The hemostasis effects of cervical ligation in CPP puerpera underging cesarean section are reliable,thus,it deserves using widely in clinical practice.
作者
倪素娜
罗巧玲
梁燕茹
NI Suna;LUO Qiaoling;LIANG Yanru(Shijiazhuang Hospital for Maternal and Child Health,Hebei,Shijiazhuang 050000,China)
出处
《河北医药》
CAS
2020年第1期78-80,84,共4页
Hebei Medical Journal
关键词
完全性前置胎盘
剖宫产
子宫颈环扎术
止血
complete placenta previa
cesarean section
cerclage of uterine cervix
hemostasis
