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目的探讨水囊填塞术联合软产道缝合治疗难治性产后出血的疗效及应用价值。方法回顾性分析2009—2016年收治的难治性产后出血31例应用水囊填塞术联合软产道缝合治疗的临床资料。结果 31例中,剖宫产17例,阴道分娩14例;产后24h出血量675~1 380mL,平均(966±250)mL。使用单水囊宫腔填塞12例,阴道填塞15例,双水囊填塞4例。水囊填塞操作3~5min,起效5~8 min,平均(6.3±0.65)min;起效后至明显止血12~50min,平均(15.4±6.7)min。31例均恢复良好,无全子宫切除,无合并晚期产后出血或继发软产道感染,均痊愈出院。结论水囊填塞术联合软产道缝合治疗难治性产后出血的疗效快,使用取材方便快捷,疗效迅速、副作用轻、费用低,还避免了子宫切除并减少输血的风险,有效降低产后出血和感染的发生,值得临床推广使用。
Objective To investigate the curative effect and application value of hydrocystic sealing in combination with soft birth canal suture in the treatment of refractory postpartum hemorrhage. Methods The clinical data of 31 cases of intractable postpartum hemorrhage treated with water bag stuffing combined with soft birth canal suture from 2009 to 2016 were retrospectively analyzed. Results Among the 31 cases, 17 cases were cesarean and 14 were vaginal delivery. The amount of bleeding after delivery was 675-1 380mL (mean, 966 ± 250) mL. The use of single-water bag intrauterine packing in 12 cases, vaginal packing in 15 cases, double-water bag packing in 4 cases. The operation of the water balloon was operated for 3 ~ 5min, with an effect of 5 ~ 8 min (average, 6.3 ± 0.65) min. After the onset of hemorrhage, the hemostasis was stopped for 12 ~ 50 min with an average of (15.4 ± 6.7) min. All 31 cases recovered well without hysterectomy, without postpartum hemorrhage complicated by secondary postpartum hemorrhage or with secondary soft birth canal infection. Conclusion The combination of hydrocele packing and soft seaming for the treatment of refractory postpartum hemorrhage has the advantages of quick curative effect, rapid curative effect, light side effect and low cost. It also avoids hysterectomy and reduces the risk of blood transfusion and effectively reduces postpartum hemorrhage and infection Occurrence, it is worth to promote clinical use.