前置胎盘剖宫产术中止血方案的选择及临床应用价值探讨

目的探讨前置胎盘剖宫产术中止血方案的选择及临床应用价值。方法选取佛山市顺德区妇幼保健院于2011年3月—2014年2月收治的177例剖宫产术中出血的前置胎盘产妇为研究对象,采用随机号码表法分成A、B、C三组,各59例,其中A组予以环形间断缝合术,B组予以"8"字缝合术,C组则采用宫腔纱条填塞术。比对3组产妇术中出血量、输血例数、输血量、术程、止血时间等治疗指标差异,行为期6个月随访,记录其相关并发症发生情况及子宫切除率。结果 1 A组产妇在出血量、输血量、术程及止血时间等治疗指标对比上明显低于B、C组,B组次之,C组止血效果最差,对比差异具有统计学意义(P0.05);2随访期内,A组并发症发生率及子宫切除率低于C组,对比差异具有统计学意义(P0.05)。结论对前置胎盘剖宫产术中出血产妇予以环形间断缝合止血方案,止血效果确切,可有效降低术后并发症发生风险,保宫效果理想,值得临床推广。

Investigation of the Choice of Hemostatic Method and the Clinical Application Value in Placenta Previa Caesarean Section

Objective To investigate the choice of hemostatic method and the clinical application value in placenta previa caesarean section.Methods 177 cases of placenta previa puerperae with hemorrhage in cesarean section treated in our hospital from March 2011 to February 2014 were selected as the research object.According to the random number table method , they were divided into A , B, C of three groups with 59 cases in each group.Group A group were treated with interrupted annular suture and group B were treated with 8-like suture while group C were treated with intrauterine packing with gauze.The intraoperatve blood loss , cases receiving blood transfusion , blood transfusion volume , course of surgery , hemostatic time and other treatment indexes were compared between the three groups.With 6 months of follow-up during behavioral period , the incidence of related complications and the rate of hysterectomy were recorded.Results ①The bleeding volume , cases receiving blood transfusion , blood transfusion volume , course of surgery , hemostatic time and other treatment indexes in group A were significantly lower than those in group B and C , followed by group B and the hemostatic effect in group C was the worst ( P<0.05 ); ②During the follow-up period , there were no significant differences in the incidence of complications and the rate of hysterectomy between group A they were lower than those in group C ( P<0.05 ) .Conclusion To adopt interrupted annular suture hemostasis in puerperae with hemorrhage during placenta previa cesarean section , the hemostatic effect is definite.It can effectively reduce the risk of postoperative complications and the uterine protection effect is ideal , which is worthy of clinical promotion.