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目的探讨子宫背带式缝合在宫缩乏力产后出血中的应用价值。方法选择2012年1月—2014年1月收治的剖宫产术后宫缩乏力大出血患者80例,随机分为两组,各40例,患者均在腰硬联合麻醉下完成手术,发生宫缩乏力后,首先进行子宫按摩,联合缩宫素宫体及静脉注射,其中观察组使用背带式缝合,对照组继续观察,必要时以子宫切除结束治疗。比较两组出血持续时间、术中出血量、术后出血量以及并发症情况。计量资料比较使用t检验,组间率的比较采用χ2检验,P<0.05差异有统计学意义。结果观察组出血持续时间为(25.6±5.3)min,短于对照组的(36.9±8.5)min(P<0.05),术中出血量为(458.6±28.9)ml,术后出血量为(154.3±17.2)ml,均少于对照组的(1 152.6±57.8)ml和(415.8±38.6)ml(均P<0.05)。观察组子宫切除占5.0%,低于对照组的27.5%(P<0.05)。观察组发生失血性休克、产褥感染分别为7.5%、5.0%,低于对照组的37.5%、25.0%(均P<0.05)。结论子宫背带式缝合能有效制止子宫出血,降低子宫切除率,减少并发症的发生。
Objective To investigate the value of uterine strap suture in postpartum hemorrhage with uterine atony. Methods Eighty patients with uterine bleeding after cesarean section were selected from January 2012 to January 2014 and were randomly divided into two groups (n = 40 in each group). All patients underwent surgery under combined spinal and epidural anesthesia. After fatigue, the first uterine massage, combined with oxytocin Palace and intravenous injection, the observation group using the strap suture, the control group continued observation, if necessary, to end the treatment of hysterectomy. The duration of bleeding, intraoperative blood loss, postoperative blood loss and complications were compared between the two groups. Comparison of measurement data using t test, the comparison between groups using χ2 test, P <0.05 difference was statistically significant. Results The duration of bleeding in the observation group was (25.6 ± 5.3) min, shorter than that in the control group (36.9 ± 8.5) min (P <0.05). The blood loss in the observation group was (458.6 ± 28.9) ± 17.2) ml, both less than (152.6 ± 57.8) ml and (415.8 ± 38.6) ml in the control group (all P <0.05). Hysterectomy in the observation group accounted for 5.0%, lower than the control group 27.5% (P <0.05). Hemorrhagic shock and puerperal infection in the observation group were 7.5% and 5.0%, respectively, which were lower than 37.5% and 25.0% of the control group (all P <0.05). Conclusion Uterine strap suture can effectively stop the uterine bleeding, reduce the hysterectomy rate and reduce the incidence of complications.