宫颈多重缝扎术联合子宫动脉上行支结扎治疗难治性出血的效果

目的:探究宫颈多重缝扎术联合子宫动脉上行支结扎治疗难治性出血的效果及安全性。方法:选取2014年9月～2018年10月我院收治的剖宫产术后难治性出血患者70例进行回顾性分析,根据术中止血方式不同分为两组,对照组(35例)患者行宫腔纱布填塞联合双侧子宫动脉上行支结扎术,观察组(35例)患者行宫颈多重缝扎术联合双侧子宫动脉上行支结扎术。比较两组患者的止血效果、术中和术后出血量、术后恢复情况及并发症的发生情况。结果:治疗后,观察组患者的止血有效率显著高于对照组(P0.05);观察组患者术中和术后2 h、12 h和24 h的出血量显著低于对照组(P0.05);两组患者月经量和子宫复旧情况相比无统计学差异(P0.05),观察组患者住院时间、恶露持续时间、月经恢复时间均显著短于对照组(P0.05);两组患者不良反应发生率相比无统计学差异(P0.05)。结论:宫颈多重缝扎术联合子宫动脉上行支结扎可显著降低术中和术后出血量,止血效果较好,可促进患者术后恢复,且不增加并发症的发生率。

Effect of Multiple Cervical Suture Ligation Combined with Uplink Ligation of Uterine Artery in the Treatment of Refractory Bleeding

ABSTRACT Objective: To explore the effect and safety of multiple cervical suture ligation combined with ascending branch ligation of uterine artery in the treatment of refractory bleeding. Methods: 70 cases of patients with intractable hemorrhage after cesarean from September 2014 to October 2018 in our hospital were selected and divided into two groups according to different operation method, the control group (35 cases) was treated with intrauterine gauze tamponade combined bilateral uterine artery ascending branch ligation, while the observation group (35 cases) was treated by multiple cervical suture ligation combined with bilateral uterine artery ascending branch ligation operation. The hemostatic effect, intraoperative and postoperative blood loss, postoperative recovery and incidence of complications were compared between the two groups. Results: The hemostatic efficiency of observation group was significantly higher than that of the control group(P<0.05). The amount of bleeding at 2 h, 12 h and 24 h after operation in the observation group were significantly lower than those in the control group(P<0.05). There was no statistically significant difference between the two groups in the menstrual quantity and uterine involution(P>0.05). The length of hospital stay, duration of lochia rubra and recovery time in the observation group were significantly shorter than those of the control group(P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Multiple cervical suture ligation combined bilateral uterine artery ascending branch ligation operation can significantly reduce the amount of intraoperative and postoperative blood loss and promote the postoperative recovery without increasing the incidence of complications.