CAJ | 학술논문

目的：探讨胎儿娩出前止血带套扎子宫下段防治中央性前置胎盘剖宫产术中产后出血的有效性及安全性。方法将本院82例中央性前置胎盘行剖宫产术的患者以住院号尾数单双号随机分为研究组(胎儿娩出前采用止血带套扎子宫下段组)及对照组(常规手术组)。结果研究组术中出血量少于对照组，产后出血发生率、输血率及输血量低于对照组，差异有统计学意义(P <0．05)；新生儿窒息发生率及脐血血气分析 pH 值，两组差异无统计学意义(P >0．05)。结论中央性前置胎盘剖宫产术中在胎儿娩出前使用止血带套扎子宫下段，阻断双侧子宫动脉上行支，能显著降低术中出血量，降低输血病例，几乎可避免子宫切除病例，可一定程度预防产后出血的发生，且对新生儿结局无不良影响。
목적：탐토태인면출전지혈대투찰자궁하단방치중앙성전치태반부궁산술중산후출혈적유효성급안전성。방법장본원82례중앙성전치태반행부궁산술적환자이주원호미수단쌍호수궤분위연구조(태인면출전채용지혈대투찰자궁하단조)급대조조(상규수술조)。결과연구조술중출혈량소우대조조，산후출혈발생솔、수혈솔급수혈량저우대조조，차이유통계학의의(P <0．05)；신생인질식발생솔급제혈혈기분석 pH 치，량조차이무통계학의의(P >0．05)。결론중앙성전치태반부궁산술중재태인면출전사용지혈대투찰자궁하단，조단쌍측자궁동맥상행지，능현저강저술중출혈량，강저수혈병례，궤호가피면자궁절제병례，가일정정도예방산후출혈적발생，차대신생인결국무불량영향。
Objective To investigate the effectiveness and safety of tourniquet ligation in the lower uterine segment pre-vention and treatment of postpartumhemorrhage in placenta previa cesarean section. Methods Divided 82 cases of placenta previa into study group (tourniquet ligation in the lower uterine segment group before fetus delivery) and control group (routine operation group). Results Blood loss was less than that of the control group ( P < 0. 05),the incidence of postpartumhemorrhage,rate of blood transfusion and transfusion volume was lower than those of control group (P < 0. 05), the rate of neonatal asphyxia no signif-icant difference between the two groups(P > 0. 05),Umbilical cord blood gas analysis of the differences between the two groups of pHhad no statistical significance (P > 0. 05). Conclusion Cesarean section in placenta previa,tourniquet ligation of lower uterine segment before fetus delivery,can significantly reduce the blood loss,almost can avoidhysterectomy cases,may prevent the occur-rence of postpartumhemorrhage,and no adverse impact on neonatal outcome.