难治性产后出血子宫网压缝合术治疗的多中心临床有效性观察
Clinical Observation of the Efficacy of the Uterine Net-Like Compression Su-ture for Treating Intractable Postpartum Hemorrhage
王晨笛 1朱天行 1雷颖 1李莉 2李南 3赵萍 4钟英 5王成英6
作者信息
- 1. 成都市温江区妇幼保健院妇产科,四川 成都 611130
- 2. 成都市第五人民医院妇产科,四川 成都 611130
- 3. 成都市妇女儿童中心医院产前诊断科,四川 成都 610091
- 4. 四川省邛崃市妇幼保健院妇产科,四川 邛崃 611530
- 5. 成都市金堂纺织妇产医院妇产科,四川 金堂 610404
- 6. 西南兵工成都医院妇产科,四川 成都 611700
- 折叠
摘要
目的:探讨子宫网压缝合术在难治性产后出血(PPH)治疗中的应用价值.方法:回顾性分析2015 年1 月至2023 年3 月成都市6 家妇儿医联体医院84 例难治性PPH患者保守性手术治疗资料,按手术方法分为2 组:B-Lynch缝合术(对照组)41 例,子宫网压缝合术(观察组)43 例.观察 2组临床治疗有效性,对比2 组围手术期相关指标及临床治疗结局.结果:①对照组31 例成功止血并保留子宫,治疗有效率75.61%,观察组42 例成功止血并保留子宫,治疗有效率97.67%,2 组比较差异有统计学意义(P＜0.01).②术中各项诊断、术前出血量,2 组比较差异均无统计学意义(P＞0.05);术中、术后2h出血量观察组低于对照组,差异有统计学意义(P＜0.01);术后输血观察组低于对照组,差异有统计学意义(P＜0.01);术后转ICU、住院天数观察组均低于对照组,差异有统计学意义(P＜0.01).③随访时间10～48 个月,73 例保留子宫患者术后 12 个月内均恢复月经,对照组13 例(41.94%)出现月经量减少及周期改变,观察组 6 例(14.29%)出现月经量减少及周期改变,2 组差异有统计学意义(P＜0.01);对照组 5 例(16.13%)有后续妊娠,观察组 12 例(28.57%)有后续妊娠,2 组差异无统计学意义(P＞0.05).结论:子宫网压缝合及B-Lynch缝合术对难治性PPH治疗均具有良好的临床疗效,子宫网压缝合术在术中、术后出血量,以及术后输血、住院天数方面具有较好治疗优势.子宫网压缝合术对医疗器械及材料无特殊要求,对医疗条件有限的基层产科具有重要推广应用价值.
Abstract
Objective:To explore the application value of uterine net-like compression suture in postpartum hemorrhage(PPH).Methods:The data of 84 refractory PPH patients from six hospitals specialized in children and women in Chengdu from January 2015 to March 2023 were retrospectively analyzed.They were divided into two groups according to the surgical methods:41 cases of B-Lynch suture(control group)and 43 cases of uterine net-like compression suture(observation group).The clinical efficacy of the two methods was observed,and the perioperative indicators and clinical outcomes were compared between the two groups.Results:①31 cases in the control group and 42 cases in the observation group,were successfully hemostatic and retained the uterus,with effective rates of 75.61%and 97.67%,respectively.The difference was statistically significant(P＜0.01).②There were no significant differences in the rates of all preoperative diagnosis and preoperative blood loss between the two groups(P＞0.05);in the observation group,the intraoperative and 2 h postoperative blood loss,the units of postoperative blood transfusion,the incidence rate of requiring postoperative intensive care and the hospitalization days,were less than those in the control group(P＜0.01).③During a follow-up period of 10-48 months,all 73 pa-tients without hysterectomy recovered menstrual cycles within 12 months after the surgery.Thirteen cases experi-enced reduced menstrual flow with cycle changes in the control group(41.94%),while 6 cases experienced in the observation group(14.29%),and the difference was statistically significant(P＜0.01);5 cases(16.13%)had sub-sequent pregnancy in the control group,while 12 cases(28.57%)had in the other,with no significant difference(P＞0.05).Conclusions:The two uterine sutures for refractory PPH have both achieved good clinical curative effects,and the uterine net-like compression suture shows therapeutic advantages on intraoperative and postoper-ative blood loss,postoperative blood transfusion,and hospitalization days.The uterine net-like compression suture has no special requirements for medical devices or materials,and thus has important popularization and applica-tion value for primary obstetrics with limited medical conditions.
关键词
难治性产后出血/B-Lynch缝合术/子宫网压缝合术/有效性观察Key words
Refractory postpartum hemorrhage/B-Lynch suture/Uterine net-like compression suture/Efficacy observation引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据