前置胎盘剖宫产术中两种止血方法对比分析

目的:对比碘伏纱条宫腔填塞法及双侧子宫动脉上行支结扎法在前置胎盘剖宫产术中的止血效果。方法:回顾性分析因前置胎盘231例行剖宫产术中两种止血方法的效果及切口愈合情况,并分析两种止血方法中失败原因。结果:对边缘性前置胎盘或中央性前置胎盘子宫动脉结扎组术中出血量少于宫腔填塞组,对中央性前置胎盘子宫动脉结扎组术后出血量少于宫腔填塞组。宫腔填塞失败原因为子宫体较大,肌纤维受损,收缩不良;子宫动脉上行支结扎失败原因为子宫下段创面活动性出血,联合局部缝扎及宫腔填塞可有效止血。结论:临床治疗中双侧子宫动脉结扎法更优,必要时可联合宫腔填塞法。

Comparative analysis on two hemostatic methods during cesarean section of placental presentation

Objective:To compare the hemostatic effects of uterine tamponade via iodophor sliver and ligation of bilateral ascending uterine artery during cesarean section of placental presentation.Methods:The effects of two hemostatic methods and healing statuses of 231 patients during cesarean section of placental presentation were analyzed retrospectively,and the causes of failure of the two methods were analyzed.Results:The amount of blood loss in patients with marginal or central placental presentation in ligation group was less than that in uterine tamponade group;the amount of blood loss in patients with central placental presentation in ligation group was less than that in uterine tamponade group.The causes of failure of uterine tamponade were large uterine body,damage of uterine muscle fiber,and bad uterine contraction;the causes of failure were active bleeding of wound surface in lower uterine segment,combined local ligation and uterine tamponade could stop bleeding effectively.Conclusion:Ligation of bilateral ascending uterine artery is better in clinical treatment,if necessary,uterine tamponade can be used jointly.