子宫局部贯穿式缝合止血在产后出血中应用.docVIP

子宫局部贯穿式缝合止血在产后出血中应用 　　[摘要] 目的 探究子宫局部贯穿式缝合止血在产后出血中的应用价值。方法 整群选择在该院2014年1月1日―2015年12月1日之间剖宫产术中因子宫收缩乏力而导致的产后出血患者56例，随机分为观察组和对照组，各28例，分别以贯穿式缝合止血、双侧髂内动脉结扎及双侧子宫动脉结扎的方法为患者治疗，观察两组患者术中以及术后的情况对比。结果 观察组患者术中所用的时间以及术中的出血量均远远小于对照组患者，两组患者结果差异有统计学意义（P0.05）；观察组患者术后输血患者有2例，其他并发症均无；对照组患者术后感染7例，二次手术4例，输血患者9例，切除子宫的有6例，两组患者在术后感染、输血及切除子宫方面上差异有统计学意义（P0.05）。结论 针对产后出血时，应局部应用可吸收缝线自前壁向后壁贯穿连续或“8”字缝合，不影响子宫血供，止血效果好。通过该手术方法的实施，能够有效地控制产后出血，在挽救孕产妇生命的前提下，避免了子宫切除，保留了子宫，保留了患者的生育功能。 　　[关键词] 贯穿式缝合；子宫；产后出血 　　[中图分类号] R714.46 [文献标识码] A [文章编号] 1674-0742（2016）04（a）-0107-02 　　[Abstract] Objective To discuss the application value of uterine local perforator-type suture hemostasis in postpartum hemorrhage. Methods 56 cases of patients with postpartum hemorrhage caused by uterine atony in cesarean section treated in our hospital from January 1， 2014 to December 1， 2015 were selected and randomly divided into the observation group and the control group with 28 cases in each， and they were respectively treated with perforator-type suture hemostasis， bilateral internal iliac artery ligation and bilateral uterine artery ligation， the intraoperative and postoperative conditions were observed and compared between the two groups. Results The operation time and intraoperative blood loss in the observation group were far less than those in the control group， and the differences was obvious between the two groups with statistical significance， P0.05， in the observation group， postoperative blood transfusion occurred to 2 cases and there was no other complications， in the control group， postoperative infection occurred to 7 cases， second operation occurred to 4 cases， transfusion occurred to 9 cases， uterus excision occurred to 6 cases， the differences in the postoperative infection， transfusion and uterus excision were obvious with statistical significance， P0.05. Conclusion For postpartum hemorrhage， we should locally apply absorbable suture for perforative and contious suture from anterior wall to paries posterior o