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我院于1990年1月～1997年6月对16例剖宫产术中大出血行宫腔纱布填塞止血,达到保留子宫,迅速止血的效果,现报告如下。 1 临床资料 16例中年龄最大39岁,最小24岁,平均年龄27。均为第1胎分娩,2例孕32周,2例孕33～37周。其余均为足月分娩。宫腔填塞前出血量最多为1900ml,最少出血量为860ml,出血量人于1000 ml13例。出血原因:前置胎盘4例(中央性),胎盘粘连6例,宫缩乏力6例,2例为产前子痫大量镇静解痉药物治疗后行剖宫产术。宫腔填塞方法及时间:16例均在手术中经多种方法止血无效。用宽5～6 cm,长约30 cm纱条3～4条叠成4层,丝线缝合连接成约100～120 cm长纱条(干),卵园钳夹住纱条的一端从宫底部开始,左右横形依次填塞压紧,不留空隙,达子宫下段宫颈外口达阴道外口,然后常规缝合子宫切口,避免缝住纱布,术后给用大量抗生素、缩宫素,观察血压变化及宫底高度,阴道口纱布是否有渗血。宫腔填塞后最短24h最长37h
Our hospital from January 1990 to June 1997 16 cases of cesarean section hemorrhage uterine gauze packing to stop bleeding, to retain the uterus, the effect of rapid bleeding, are as follows. 1 clinical data of 16 cases, the oldest 39 years old, minimum 24 years old, mean age 27 years. The first childbirth, 2 cases of pregnant 32 weeks, 2 cases of pregnancy 33 to 37 weeks. The rest are full-term delivery. Uterine bleeding before packing up to 1900ml, a minimum of 860ml of bleeding, bleeding in 1000ml13 cases. Bleeding causes: placenta previa in 4 cases (central), placental adhesion in 6 cases, uterine atony in 6 cases, 2 cases of prenatal eclampsia sedation antispasmodic drug treatment after cesarean section. Methods and time of intrauterine packing: 16 cases were in operation by a variety of methods to stop bleeding is invalid. With a width of 5 ~ 6 cm, length 30 cm gauze 3-4 stacked into 4 layers, silk suture connected to about 100 ~ 120 cm long gauze (dry), egg garden tong grip the end of the gauze from the bottom of the palace Beginning, followed by horizontal packing around the compaction, leaving no gap, up to the lower uterine cervix outside the vagina mouth, and then conventional suture of the uterus, to avoid suture gauze, postoperative use of a large number of antibiotics, oxytocin, blood pressure changes and Palace height, vaginal gauze whether there is bleeding. The shortest 24h after the intrauterine packing up to 37h