子宫动脉上行支结扎术联合宫腔球囊填塞术在剖宫产产后出血中的应用效果

doi:10.3760/cma.j.issn.1007-1245.2023.13.024

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (13): 1882-1885.DOI: 10.3760/cma.j.issn.1007-1245.2023.13.024

子宫动脉上行支结扎术联合宫腔球囊填塞术在剖宫产产后出血中的应用效果

陈丽芳¹ 郑玉¹ 李剑琦²

¹陆丰市人民医院妇产科，汕尾　516500；²广州医科大学附属第三医院妇产科广东省产科重大疾病重点实验室，广州　510150

收稿日期:2023-03-24 出版日期:2023-07-01 发布日期:2023-07-21
通讯作者: 李剑琦，Email：2014683021@gzhmu.edu.cn

Application effect of ligation of ascending branch of uterine artery combined with uterine balloon tamponade in postpartum hemorrhage of cesarean section

Chen Lifang¹, Zheng Yu¹, Li Jianqi²

¹Department of Obstetrics and Gynecology, The People's Hospital of Lufeng, Shanwei 516500, China; ²Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Major Obstetric Diseases of Guangdong Province, Guangzhou 510150, China

Received:2023-03-24 Online:2023-07-01 Published:2023-07-21
Contact: Li Jianqi, Email: 2014683021@gzhmu.edu.cn

摘要/Abstract

摘要：

目的　探讨双侧子宫动脉上行支结扎术联合宫腔球囊填塞术在剖宫产产后出血中的应用效果。方法　本文为回顾性研究，选取2019年1月至2021年12月在陆丰市人民医院应用双侧子宫动脉上行支结扎联合宫腔球囊填塞术（研究组）或单纯应用宫腔球囊填塞术（对照组）治疗的具有产后出血高危因素的剖宫产产妇各100例。研究组年龄为（28.07±4.78）岁，孕周34⁺³～40⁺⁵周；对照组年龄（27.74±3.90）岁，孕周34⁺⁴～40⁺³周。统计分析两组产后出血量、手术时间、住院时间和术前术后血红蛋白（HGB）变化的差异，并且分析两组的产后并发症及不良反应的发生率。用独立样本t检验、χ²检验。结果　研究组的产后出血量为（1 208.0±327.3）ml，明显少于对照组（1 547.8±364.3）ml（t=6.938 0，P<0.000 1）；研究组的术后HGB为（81.2±15.1）g/L，明显高于对照组的（70.8±17.3）g/L（t=3.219 0，P=0.001 5）；研究组和对照组的手术时间分别为（84.7±15.2）min和（82.7±16.1）min，住院时间分别为（8.3±1.4）d和（8.0±1.6）d，两组比较差异均无统计学意义（均P>0.05）；研究组和对照组产后并发症及不良反应方面比较差异无统计学意义（P>0.05）。结论　双侧子宫动脉上行支结扎术联合宫腔球囊填塞术在剖宫产产后出血中的治疗效果优于单纯宫腔球囊填塞术。

关键词:

产后出血, 剖宫产, 双侧子宫动脉上行支结扎术, 宫腔球囊填塞术

Abstract:

Objective　To investigate the application effect of bilateral ascending uterine artery ligation combined with uterine balloon tamponade in postpartum hemorrhage of cesarean section. Methods　A retrospective analysis was made on 100 cases of cesarean section with high risk factors for postpartum hemorrhage treated by bilateral ascending uterine artery ligation combined with uterine balloon tamponade (study group) and 100 cases of cesarean section with high risk factors for postpartum hemorrhage treated by uterine balloon tamponade alone (control group) in The People's Hospital of Lufeng from January 2019 to December 2021. The study group was (28.07±4.78) years old, and the gestational age was 34⁺³ - 40⁺⁵ weeks; the control group was (27.74±3.90) years old, and the gestational age was 34⁺⁴ - 40⁺³ weeks. The differences of postpartum hemorrhage, operation time, hospital stay, and hemoglobin (HGB) change before and after surgery between the two groups were statistically analyzed, and the incidence of postpartum complications and adverse reactions in the two groups were analyzed. Independent sample t test and χ² test were used. Results　The postpartum hemorrhage volume in the study group was (1 208.0±327.3) ml, which was significantly lower than that in the control group [(1 547.8±364.3) ml] (t=6.938 0, P<0.000 1). The postoperative HGB of the study group was (81.2±15.1) g/L, which was significantly higher than that of the control group [(70.8±17.3) g/L] (t=3.219 0, P=0.001 5). The operation time of the study group and the control group were (84.7±15.2) min and (82.7±16.1) min, and the hospitalization time of the study group and the control group were (8.3±1.4) d and (8.0±1.6) d, with no statistically significant differences between the two groups (both P>0.05). There was no statistically significant difference in the incidence of postpartum complications and adverse reactions between the two groups (P>0.05). Conclusion　Bilateral ascending uterine artery ligation combined with uterine balloon tamponade is better than uterine balloon tamponade alone in the treatment of postpartum hemorrhage of cesarean section.

Key words:

Postpartum hemorrhage, Cesarean section, Bilateral ascending uterine artery ligation, Uterine balloon tamponade

陈丽芳郑玉李剑琦.

子宫动脉上行支结扎术联合宫腔球囊填塞术在剖宫产产后出血中的应用效果 [J]. 国际医药卫生导报, 2023, 29(13): 1882-1885.

Chen Lifang, Zheng Yu, Li Jianqi.

Application effect of ligation of ascending branch of uterine artery combined with uterine balloon tamponade in postpartum hemorrhage of cesarean section [J]. International Medicine and Health Guidance News, 2023, 29(13): 1882-1885.

参考文献

[1] Liang J, Dai L, Zhu J, et al. Preventable maternal mortality: geographic/rural-urban differences and associated factors from the population-based Maternal Mortality Surveillance System in China[J]. BMC Public Health, 2011, 11:243. DOI: 10.1186/1471-2458-11-243.
[2] 中华医学会妇产科学分会产科学组.产后出血预防与处理指南(2014)[J].中华妇产科杂志,2014,49(9):641-646. DOI:10.3760/cma.j.issn.0529-567x.2014.09.001.
[3] Royal College of Obstetricians and Gynaecologists. Prevention and management of postpartum haemorrhage: green-top guideline No. 52[J]. BJOG, 2017, 124(5):e106-e149. DOI: 10.1111/1471-0528.14178.
[4] 刘兴会,杨慧霞.产后出血预防和处理措施评价[J].中华围产医学杂志,2013,16(8):449-451. DOI:10.3760/cma.j.issn.1007-9408.2013.08.001.
[5] 刘兴会,徐先明,段涛,等.实用产科手术学[M].北京:人民卫生出版社,2014:161-162.
[6] 周翠香,蒋凌明,折瑞莲,等.难治性产后出血中紧急子宫切除的高危因素及不良结局[J].广东医学,2021,42(3):308-312. DOI:10.13820/j.cnki.gdyx.20202291.
[7] 谢妮,周凌云,王毅.子宫动脉上行支结扎术在产后出血高危因素剖宫产术中的预防性应用效果[J].中国妇幼保健,2021,36(7):1464-1467. DOI:10.19829/j.zgfybj.issn.1001- 4411.2021.07.001.
[8] 彭方亮,周晓.凶险性前置胎盘剖宫产术中早期结扎双侧子宫动脉上行支的临床应用[J].重庆医学,2015,44(22):3131-3132. DOI:10.3969/j.issn.1671-8348.2015.22.043.
[9] 曾成英,万波,郭遂群,等.Bakri球囊填塞与B-Lynch缝合治疗剖宫产术产后出血的疗效比较[J].实用妇产科杂志,2016,32(6):472-474.
[10] 李相宜,麦子霞,李艳芳.宫腔球囊填塞术与宫腔塞纱术治疗剖宫产产后出血疗效分析[J].国际医药卫生导报,2016,22(6):763-766. DOI:10.3760/cma.j.issn.1007-1245.2016. 06.008.
[11] 曾丽仪,张燕菲,贾金平,等.Bakri球囊治疗产后出血的临床应用分析[J].国际医药卫生导报,2015,21(5):631-633. DOI:10.3760/cma.j.issn.1007-1245.2015.05.013.
[12] 李翠丽,万俐.B-Lynch缝合术、Bakri球囊填塞术、子宫动脉结扎术在产后出血中的临床应用[J].实用医学杂志,2015,31(12):1977-1980. DOI:10.3969/j.issn.1006-5725. 2015.12.025.

子宫动脉上行支结扎术联合宫腔球囊填塞术在剖宫产产后出血中的应用效果

Application effect of ligation of ascending branch of uterine artery combined with uterine balloon tamponade in postpartum hemorrhage of cesarean section

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

编辑推荐

Metrics

[1]	岳亚萍夏文炎牛文芳. 护理连续性服务模式对瘢痕子宫再次妊娠产妇的应用及影响 [J]. 国际医药卫生导报, 2023, 29(6): 854-858.
[2]	牛文芳岳亚萍夏文炎. 孕期营养与认知干预对重度子痫前期患者剖宫产术后下肢深静脉血栓风险的影响 [J]. 国际医药卫生导报, 2023, 29(6): 859-863.
[3]	丁延荟. 高龄初产妇剖宫产后宫缩乏力性出血的高危因素及干预措施 [J]. 国际医药卫生导报, 2023, 29(5): 688-691.