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目的探讨宫腔填塞纱条+结扎子宫动脉上行支在剖宫产术中大出血的治疗效果。方法回顾性分析2010年1月—2012年5月24例子宫下段剖宫产术中发生大出血时,除应用缩宫素、欣母沛、立止血、输血、冰冻血浆及冷沉淀外,出血量>1 000 ml时,行宫腔填塞纱条术,观察10min仍然出血时立即行子宫动脉上行支结扎术,采取上述手术后观察30min,子宫有无活动出血及止血效果。结果 24例剖宫产术中大出血产妇均行宫腔填塞纱条术,其中6例在宫腔填塞纱条后出血停止,18例在宫腔填塞纱条后因止血效果差又采用双侧子宫动脉上行支结扎术,观察30min,宫腔基本不出血时,将纱条末端通过宫颈放到阴道内,于术后24~48h取出,纱条取出后未再发生子宫大出血情况,止血效果满意,不影响子宫复旧、月经复潮。结论宫腔填塞纱条+子宫动脉上行支结扎术应用于剖宫产术中止血有效、迅速,是一种积极有效控制剖宫产术后出血的措施。
Objective To investigate the therapeutic effect of intrauterine packing gauze + ligation of uterine artery in the cesarean section in the ascending branch. Methods Retrospective analysis of January 2010 -2012 May 24 cases of lower uterine bleeding in the cesarean section occurs, in addition to the application of oxytocin, Yan Xin Pei, stop bleeding, blood transfusion, frozen plasma and cryoprecipitate, the amount of bleeding > 1 000 ml, the line of intrauterine stuffing gauze line, observe the bleeding is still 10min immediately upstream uterine artery ligation, take the above operation after 30min, the uterus with or without bleeding and hemostatic effect. Results 24 cases of bleeding during cesarean section were performed intrauterine plug gauze surgery, of which 6 cases stopped bleeding in the uterine packing gauze, 18 cases in the uterine packing gauze due to poor hemostasis and bilateral uterine artery Up branch ligation, observation 30min, the uterine cavity is basically no bleeding, the end of the yarn into the vagina through the cervix, removed after 24 to 48h, removal of the umbilical cord no longer bleeding, the hemostatic effect is satisfactory, not Uterine affect the elderly, menstrual resurgence. Conclusions Uterine plug sliver + uterine artery ligation is an effective and effective method for stopping bleeding during cesarean section. It is a measure to effectively and effectively control bleeding after cesarean section.