摘要
目的观察双侧子宫动脉结扎术联合水囊压迫治疗前置胎盘剖宫产出血的临床疗效。方法回顾性分析2018年6月至2020年6月秦皇岛市妇幼保健院收治的170例前置胎盘剖宫产出血产妇的病例资料,按照治疗方法的不同将其分为观察组(n=90)与对照组(n=80)。观察组产妇行双侧子宫动脉结扎术联合水囊压迫治疗,对照组产妇行宫腔填塞纱布止血治疗。比较两组产妇的手术情况、凝血功能变化情况及术后并发症发生情况。结果观察组与对照组产妇在手术时间、填塞物留置时间及术中、术后24 h出血量比较分别为(50.83±3.36)min vs.(65.29±3.27)min、(936.03±64.14)ml vs.(1824.49±132.25)ml、(204.03±13.14)ml vs.(462.49±17.25)ml、(19.83±2.36)h vs.(23.29±2.27)h,差异有统计学意义(P<0.05)。治疗前,两组产妇的凝血指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBI)和凝血酶时间(TT)比较,差异无统计学意义(P>0.05);治疗后,观察组产妇PT、APTT、TT、FBI指标分别为(12.02±1.56)s、(35.26±2.24)s、(15.51±2.26)s、(3.98±0.52)g/L,与对照组比较差异有统计学意义(t=12.8141,19.986,18.610,5.909,P<0.05)。术后随访显示,观察组产妇的并发症发生率较对照组低(4.4%vs.15.0%),差异具有统计学意义(χ^2=4.390,P<0.05)。结论双侧子宫动脉结扎术联合水囊压迫治疗前置胎盘剖宫产出血,对产妇凝血功能改善显著,有利于减少出血量,降低并发症发生率,值得临床推广。
Objective To observe the efficacy of bilateral uterine artery ligation combined with water sac compression in the treatment of placenta previa cesarean section hemorrhage.Methods A retrospective study was conducted on 170 women with hemorrhage of placenta previa in cesarean section admitted to the Maternal and Child Health Hospital of Qinhuangdao City,from June 2018 to June 2020,and they were divided into an observation group(n=90)and a control group(n=80)according to different treatment methods.Women in the observation group received bilateral uterine artery ligation combined with water sac compression,and women in the control group received gauze packing to stop bleeding.The operation status,coagulation function changes and the postoperative complications of the two groups were compared.Results The comparison between the observation group and the control group in operation time,tampon indwelling time,and intraoperative and 24-h postoperative blood loss were(50.83±3.36)min vs.(65.29±3.27)min,(19.83±2.36)h vs.(23.29±2.27)h,(936.03±64.14)ml vs.(1824.49±132.25)ml,and(204.03±13.14)ml vs.(462.49±17.25)ml,respectively,the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the coagulation indicators prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FBI)and thrombin time(TT)between the two groups(P>0.05).After treatment,the PT,APTT,TT and FBI indicators of the observation group were(12.02±1.56)s,(35.26±2.24)s,(15.51±2.26)s,(3.98±0.52)g/L,of the control group were(t=12.8141,19.986,18.610,5.909),and the differences were statistically significant(P<0.05).Postoperative follow-up showed that the incidence of complications in the observation group was lower than that in the control group(4.4%vs.15.0%),and the difference was statistically significant(χ^2=4.390,P<0.05).Conclusion Bilateral uterine artery ligation combined with water sac compression for the treatment of placenta previa cesarean section hemorrhage can significantly improve the coagulation function of puerpera,reduce the amount of blood loss,reduce the incidence of complications,and is worthy of clinical promotion.
作者
魏娜
杨青
张晶
宋伟夫
朱颖
WEI Na;YANG Qing;ZHANG Jing(Department of Obstetrics,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao Hebei 066000,China)
出处
《临床和实验医学杂志》
2020年第18期1991-1994,共4页
Journal of Clinical and Experimental Medicine
基金
河北省科学技术厅自然科学基金项目(编号:15277793D)
秦皇岛市科学技术局科研课题(编号:201703A134)。
关键词
前置胎盘
剖宫产出血
双侧子宫动脉结扎术
水囊压迫治疗
凝血功能
Placenta previa
Cesarean section hemorrhage
Bilateral uterine artery ligation
Water sac compression treatment
Blood coagulation function
