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目的观察子宫体双侧弓形动脉缝扎术(简称止血术)用于剖宫产术中子宫收缩乏力性出血的临床效果。方法取广元市中心医院2010年3月至2013年1月收治的剖宫产术中子宫收缩乏力性出血患者120例,设为实验组,通过子宫体双侧弓形动脉缝扎术止血;另取同期收治的采用常规止血方式的患者120例设为对照组。对比两组患者的即刻止血率、止血有效率和总有效率等,术后通过阴道彩超测定患者子宫血循环指标子宫动脉阻抗指数(RI)和收缩期峰值与舒张末期血流速度(S/D)比值。结果实验组患者的术中出血量、手术耗时和产褥病发生率均较对照组更低,实验组患者的即刻止血率和总有效率均较对照组更高,差异均具统计学意义(P<0.05);两组患者术后子宫血循环指标RI和S/D比值比较差异无统计学意义(P<0.05)。结论剖宫产术中子宫收缩乏力性出血采用止血术能有效减少患者术中出血和手术耗时,止血效果显著且并发症发生率更低。
Objective To observe the clinical effect of bilateral arcuate arcuate suture (referred to as hemostasis) for uterine contraction and fatigue bleeding in cesarean section. Methods One hundred and twenty patients with uterine atresia and fatigue in cesarean section who were treated in Guangyuan Central Hospital from March 2010 to January 2013 were selected as the experimental group and were given suture through bilateral uterine artery. The same period treated with conventional hemostasis method in 120 patients as a control group. Immediate bleeding rate, effective rate of hemostasis and total effective rate were compared between the two groups. Uterine blood flow index (RI) and peak systolic and diastolic blood flow velocity (S / D) ratio. Results In the experimental group, the intraoperative blood loss, operation time and the incidence of puerperal disease were lower than those in the control group. The immediate hemostatic rate and total effective rate in the experimental group were significantly higher than those in the control group (P <0.05). There was no significant difference in RI and S / D ratio between the two groups in postoperative uterine blood circulation (P <0.05). Conclusion Cesarean section with uterine atony bleeding using hemostasis can effectively reduce the intraoperative bleeding and surgery time-consuming, bleeding effect is significant and the incidence of complications is lower.