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目的探讨宫颈捆扎联合多重正方形缝合在治疗剖宫产产后出血的效果。方法将2008~2013年在永川区中医院妇产科采用宫颈捆扎联合多重正方形缝合术治疗剖宫产产后出血的35例患者作为研究组,2008年前后采用传统方法如“8”字缝合术、结扎双侧子宫动脉、子宫填塞纱条等治疗剖宫产产后出血的35例患者作为对照组;观察两组患者产后出血量、手术时间、子宫切除率、产褥病率和子宫复旧情况。结果研究组的手术时间、术后出血量以及产褥病发病率[分别为(52±5)min、(469±12)m L、5.7%]均优于对照组[分别为(71±6)min、(756±10)m L、22.9%](P<0.05)。子宫切除率、子宫复旧正常率两组比较差异无统计学意义(P>0.05)。结论宫颈捆扎联合多重正方形缝合术具有操作简单,止血迅速,安全有效,能保留子宫等优点,在治疗剖宫产产后出血方面效果显著。
Objective To investigate the effect of cervical banding combined with multiple square sutures in the treatment of hemorrhage after cesarean section. Methods A total of 35 patients with postpartum hemorrhage after cesarean section were treated by cervical banding combined with multiple square sutures in the obstetrics and gynecology department of the Yongchuan Hospital of Traditional Chinese Medicine from 2008 to 2013 as the study group. Before and after 2008, traditional methods such as “8” suture 35 cases of cesarean section postpartum hemorrhage treated by bilateral uterine artery ligation and sutured uterus were used as the control group. The postpartum hemorrhage, operation time, hysterectomy rate, puerperal morbidity and uterine involution were observed in two groups . Results The operative time, the amount of postoperative bleeding and the incidence of puerperal disease in the study group were (52 ± 5) min and (469 ± 12) m L, respectively, 5.7% ) min, (756 ± 10) m L, 22.9%] (P <0.05). Hysterectomy rate and uterine involution rate were no significant difference between the two groups (P> 0.05). Conclusions Cervical banding combined with multiple square suture has the advantages of simple operation, rapid hemostasis, safe and effective, can retain the uterus, etc., in the treatment of bleeding after cesarean section.