CAJ | 학술논문

目的通过对剖宫产术产后出血患者分别用宫腔填塞纱条止血法和用宫腔下段填塞Foley's导尿管小水囊止血法进行比较分析，探讨两种方法控制剖宫产术产后出血效果的优劣。方法回顾性分析2010年6月至2012年12月在广西壮族自治区妇幼保健院行剖宫产，出现产后出血的单胎妊娠产妇，经常规使用宫缩剂或按摩子宫后效果不佳者，排除凝血功能障碍、软产道损伤以及胎盘残留或胎盘植入后，随机分为A、B两组，分别采用宫腔填塞纱条法（A组）和宫腔下段填塞小水囊法（B组）进行止血。比较两组填塞方法的操作时间、出血量和术后病率。结果手术时间B组比A组用时短，差异有统计学意义（ t＝5．746，P＜0．001）；出血量24小时内B组比A组少，差异有统计学意义（t＝7．402，P＜0．001）；术后病率A、B两组比例分别为1．96％和1．72％，差异无统计学意义（χ2＝0．002，P＝0．719）。两种宫腔操作方法效果均满意，无再次出血病例。结论宫腔下段填塞Foley's导尿管小水囊控制剖宫产术产后出血的止血效果好，操作简单方便，取材容易且价格低廉，可有效减少手术操作时间，整体效果明显优于宫腔填塞纱条法，利于临床推广，特别是在基层医院更有实用价值。
목적통과대부궁산술산후출혈환자분별용궁강전새사조지혈법화용궁강하단전새Foley's도뇨관소수낭지혈법진행비교분석，탐토량충방법공제부궁산술산후출혈효과적우렬。방법회고성분석2010년6월지2012년12월재엄서장족자치구부유보건원행부궁산，출현산후출혈적단태임신산부，경상규사용궁축제혹안마자궁후효과불가자，배제응혈공능장애、연산도손상이급태반잔류혹태반식입후，수궤분위A、B량조，분별채용궁강전새사조법（A조）화궁강하단전새소수낭법（B조）진행지혈。비교량조전새방법적조작시간、출혈량화술후병솔。결과수술시간B조비A조용시단，차이유통계학의의（ t＝5．746，P＜0．001）；출혈량24소시내B조비A조소，차이유통계학의의（t＝7．402，P＜0．001）；술후병솔A、B량조비례분별위1．96％화1．72％，차이무통계학의의（χ2＝0．002，P＝0．719）。량충궁강조작방법효과균만의，무재차출혈병례。결론궁강하단전새Foley's도뇨관소수낭공제부궁산술산후출혈적지혈효과호，조작간단방편，취재용역차개격저렴，가유효감소수술조작시간，정체효과명현우우궁강전새사조법，리우림상추엄，특별시재기층의원경유실용개치。
Objective To compare the effect of intrauterine packing method with gauze and tamping with Foley 's catheter in control of postpartum hemorrhage after cesarean section and to discuss the advantage and disadvantage of two methods .Methods From June 2010 to December 2012, cases of postpartum hemorrhage after cesarean section performed in Guangxi Maternity and Child Health Hospital were retrospectively analyzed .With poor effect of conventional tocolytic agents or uterus massage but without coagulation disorders , injury of soft birth canal , residue of placenta or placenta implantation , they were randomly divided into group A and group B with the method of intrauterine packing with gauze and the method of tamping with Foley's catheter, respectively.The operation time, blood loss and postoperative morbidity of two groups were compared .Results The mean operation time of group B was shorter than that of group A , and the amount of bleeding within 24h was less in group B than in group A .The differences were significant ( t value was 5.746 and 7.402, respectively, both P<0.001).The postoperative morbidity was 1.96%and 1.72%in group A and group B, respectively, and there was no significant difference(χ2 =0.002,P=0.719).The effect of two methods was satisfying, and there was no case with hemorrhage again. Conclusion Intrauterine packing with tamping Foley's catheter in lower uterine segment to control postpartum hemorrhage achieves good effect with convenient operation , low cost and short time .The overall effect of it is obviously superior to the method of intrauterine packing with gauze , and it is conducive to clinical practice especially in primary hospitals .