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目的研究双侧子宫动脉上行支结扎应用在中央性前置胎盘剖宫产术中大出血的效果。方法选取重庆市妇幼保健院2015年3月至2016年3月中央性前置胎盘剖宫产术中出现大出血情况的产妇120例,根据手术中采用的不同处置方式分为研究组63例和对照组57例。对照组术中采取常规手段止血,出血情况无法阻止时对髂内动脉进行结扎或切除子宫;研究组术中采取常规方法止血并对双侧子宫动脉上行支进行结扎。比较两组术中出血及输血情况、手术时间、术后恢复情况。结果研究组术中出血量[(362.42±94.12)mL]显著低于对照组[(604.67±124.38)mL](P<0.05);研究组术后24 h出血量[(442.43±124.52)mL]显著低于对照组[(734.56±218.34)mL](P<0.05);研究组输血量[(182.45±26.53)mL]显著低于对照组[(337.56±34.78)mL](P<0.05);研究组的手术时间显著短于对照组(P<0.05);两组产后长期恢复情况比较差异无统计学意义(P>0.05)。结论在中央性前置胎盘剖宫产术中出现大出血情况下对双侧子宫动脉上行支进行结扎来止血,能够缩短手术时间,减少产妇失血,减少输血量。
Objective To study the effect of bilateral uterine artery ligation in the application of central placenta previa large bleeding. Methods From March 2015 to March 2016, 120 cases of maternal bleeding occurred in central placenta previa with cesarean section in Chongqing Maternal and Child Health Hospital from March 2015 to March 2016 were divided into study group (63 cases) and control group Group 57 cases. In the control group, conventional methods of hemostasis were adopted during operation, and the internal iliac artery was ligated or excised uterus when bleeding could not be stopped. The study group adopted conventional methods to stop bleeding and ligation of bilateral uterine artery. Blood loss and blood transfusion in both groups were compared, operation time and postoperative recovery were compared. Results The blood loss of the study group was significantly lower than that of the control group [(362.42 ± 94.12) mL [(604.67 ± 124.38) mL] (P <0.05) (P <0.05). The volume of blood transfusion in the study group [(182.45 ± 26.53) mL] was significantly lower than that in the control group [(337.56 ± 34.78) mL] The operation time of the study group was significantly shorter than that of the control group (P <0.05). There was no significant difference between the two groups in long-term postpartum recovery (P> 0.05). Conclusions In the case of central placenta previa with central hemorrhage, ligation of upper limbs of bilateral uterine arteries to stop bleeding may shorten the operation time, reduce maternal blood loss and reduce blood transfusion.