论文部分内容阅读
目的 :探求一种在高原地区、高级医疗人才短缺、技术相对不足的情况下发生剖宫产难治性出血时,如何应用简单、有效的止血方法。方法:研究组对2014年1月~2015年6月在林芝市妇幼保健院接受剖宫产术,术中发生难治性出血的10例患者,采用自制简易止血带环扎子宫下段及子宫动、静脉,即时止血;与2012年1月~2013年12月2年间剖宫产术中发生的难治性出血的15例常规方法止血作对照(对照组),对如下因素进行统计分析:出血原因、止血时间、手术时间、产后出血、严重产后出血、术中输血、切除子宫、产褥病率、腹部切口感染情况。结果:研究组采用简易止血带环扎子宫下段及子宫动、静脉即时止血、手术时间显著缩短(P<0.01),与对照组相比产后出血、严重产后出血、术中输血、切除子宫、产褥病率、腹部切口感染发生率明显减少,差异有统计学意义(P<0.05)。随访42天健康状况、生活质量研究组优于对照组。结论:高原地区剖宫产发生难治性出血,采用简易止血带环扎子宫下段及子宫动、静脉,即时止血,简单、方便、快捷、有效、安全。明显缩短手术时间,减少子宫切除及近、远期并发症发生,有效降低产后出血发生率及孕产妇死亡率。
OBJECTIVE: To explore a simple and effective method of hemostasis in refractory caesarean section bleeding in the high altitude area where there is a shortage of senior medical personnel and relatively insufficient technology. Methods: The research team conducted cesarean section in MCH from January 2014 to June 2015 in which 10 patients with intractable hemorrhage occurred during operation. A simple tourniquet was used to cerclage the lower uterine segment and uterus , Venous and immediate hemostasis. Fifteen cases of hemostasis as control group (control group) with refractory hemorrhage during cesarean section during the two-year period from January 2012 to December 2013 were analyzed. The following factors were analyzed: hemorrhage Cause, bleeding time, operation time, postpartum hemorrhage, severe postpartum hemorrhage, intraoperative blood transfusion, removal of the uterus, the rate of puerperal, abdominal incision infection. Results: In the study group, simple tourniquet cerclage was used to fasten the lower uterine segment and uterine artery and vein for immediate hemostasis. The operation time was significantly shortened (P <0.01). Compared with the control group, postpartum hemorrhage, severe postpartum hemorrhage, intraoperative blood transfusion, The prevalence of puerperal and abdominal incision infection was significantly reduced, with significant difference (P <0.05). After 42 days of follow-up, the quality of life study group was better than the control group. CONCLUSION: Refractory hemorrhage occurs in caesarean section in the plateau area. Simple tourniquet is simple and convenient, quick, effective and safe by cesarean section and uterine artery and vein with simple tourniquet. Significantly shorten the operation time, reduce hysterectomy and near and long-term complications, reduce the incidence of postpartum hemorrhage and maternal mortality.