河北医学
河北醫學
하북의학
HEBEI MEDICINE
2014年
9期
1460-1463
,共4页
林佩娜%林丹妮%袁晓如%吴婉林
林珮娜%林丹妮%袁曉如%吳婉林
림패나%림단니%원효여%오완림
前置胎盘%剖宫产%出血%改良“U”字缝合
前置胎盤%剖宮產%齣血%改良“U”字縫閤
전치태반%부궁산%출혈%개량“U”자봉합
Placenta previa%Cesarean%Hemorrhage%Improved“U”suture hemostasis
目的：探讨改良“U”字缝合止血法在前置胎盘剖宫产手术中临床止血效果。方法：选择2008年至2013年本院产科行剖宫产术分娩，且术中出血经保守治疗无效的前置胎盘产妇40例，随机数字法分为两组，各20例。均给予缩宫素和米索前列醇片止血，在此基础上，观察组患者接受改良“U”字缝合止血法，对照组接受“8”字缝合止血。并对两组产妇的手术时间、术中出血量、止血时间、术后24 h出血量、子宫切除率以及术后产褥病率等指标，以及止血效果进行比较。结果：观察组在手术时间、术中出血量、止血时间和术后24h出血量方面均显著低于对照组（ P＜0．05）；观察组未见子宫切除病例，对照组子宫切除2例，差异显著（ P＜0．05）；两组止血有效率分别为95％和70％，观察组显著高于对照组（P＜0．05），两组术后产褥病率差异不显著（P＞0．05）。结论：改良“U”字缝合止血法治疗前置胎盘剖宫产术中出血效果显著，患者术后恢复良好，操作简便，尤适于基层医院推广使用。
目的：探討改良“U”字縫閤止血法在前置胎盤剖宮產手術中臨床止血效果。方法：選擇2008年至2013年本院產科行剖宮產術分娩，且術中齣血經保守治療無效的前置胎盤產婦40例，隨機數字法分為兩組，各20例。均給予縮宮素和米索前列醇片止血，在此基礎上，觀察組患者接受改良“U”字縫閤止血法，對照組接受“8”字縫閤止血。併對兩組產婦的手術時間、術中齣血量、止血時間、術後24 h齣血量、子宮切除率以及術後產褥病率等指標，以及止血效果進行比較。結果：觀察組在手術時間、術中齣血量、止血時間和術後24h齣血量方麵均顯著低于對照組（ P＜0．05）；觀察組未見子宮切除病例，對照組子宮切除2例，差異顯著（ P＜0．05）；兩組止血有效率分彆為95％和70％，觀察組顯著高于對照組（P＜0．05），兩組術後產褥病率差異不顯著（P＞0．05）。結論：改良“U”字縫閤止血法治療前置胎盤剖宮產術中齣血效果顯著，患者術後恢複良好，操作簡便，尤適于基層醫院推廣使用。
목적：탐토개량“U”자봉합지혈법재전치태반부궁산수술중림상지혈효과。방법：선택2008년지2013년본원산과행부궁산술분면，차술중출혈경보수치료무효적전치태반산부40례，수궤수자법분위량조，각20례。균급여축궁소화미색전렬순편지혈，재차기출상，관찰조환자접수개량“U”자봉합지혈법，대조조접수“8”자봉합지혈。병대량조산부적수술시간、술중출혈량、지혈시간、술후24 h출혈량、자궁절제솔이급술후산욕병솔등지표，이급지혈효과진행비교。결과：관찰조재수술시간、술중출혈량、지혈시간화술후24h출혈량방면균현저저우대조조（ P＜0．05）；관찰조미견자궁절제병례，대조조자궁절제2례，차이현저（ P＜0．05）；량조지혈유효솔분별위95％화70％，관찰조현저고우대조조（P＜0．05），량조술후산욕병솔차이불현저（P＞0．05）。결론：개량“U”자봉합지혈법치료전치태반부궁산술중출혈효과현저，환자술후회복량호，조작간편，우괄우기층의원추엄사용。
Objective:To investigate the clinical effect of improved“U”suture hemostasis on treating in-traoperative hemorrhage with placenta previa in cesarean .Method: 40 puerpera with intraoperative hemor-rhage and placenta previa in cesarean , and conservative treatment fails were divided into two groups by ran-dom number method, and each groups with 20 cases.All the patients were given oxytocin and misoprostol tablets, patients in observation group were treated by improved“U”suture hemostasis , other patients treated by “8”suture hemostasis.Surgery time, blood loss, bleeding time, blood loss after 24h, hysterectomy rate, puerperal morbidity and effect of two groups were compared .Result:The surgery time, blood loss, bleeding time and blood loss after 24h of observation group were lower than control group ( P<0.05); There was no hysterectomy in observation group , and 2 cases with hysterctomy in control group ( P<0.05); The effective rate of two groups were 95%and 70%( P<0.05) , and there was no difference in puerperal morbidity ( P<0. 05).Conclusion: Improved“U”suture hemostasis has a good effect on treating intraoperative hemorrhage with placenta previa in cesarean and virtue of simple operation , and it's suitable for primary hospital .
