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中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2011, Vol. 07 ›› Issue (02) : 147 -150. doi: 10.3877/cma.j.issn.1673-5250.2011.02.019

论著

宫腔纱条填塞法治疗中央型前置胎盘剖宫产术中大出血70例临床分析
葛俊丽, 曾蔚越   
  1. 610041　四川成都，四川大学华西第二医院妇产科
  • 出版日期:2011-04-01

Clinical Analysis of 70 Cases With Uterine Packing in the Management of Massive Hemorrhage During Cesarean Section With Central Placenta Previa

Jun-li GE, Wei-yue ZENG   

  1. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Published:2011-04-01
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葛俊丽, 曾蔚越. 宫腔纱条填塞法治疗中央型前置胎盘剖宫产术中大出血70例临床分析[J]. 中华妇幼临床医学杂志(电子版), 2011, 07(02): 147-150.

Jun-li GE, Wei-yue ZENG. Clinical Analysis of 70 Cases With Uterine Packing in the Management of Massive Hemorrhage During Cesarean Section With Central Placenta Previa[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2011, 07(02): 147-150.

目的

探讨宫腔纱条填塞法治疗中央型前置胎盘剖宫产术中大出血的止血效果。

方法

回顾性分析2005年11月至2010年3月在本院确诊为中央型前置胎盘，并采用宫腔纱条填塞法治疗剖宫产术中大出血70例患者的临床资料，分析术中出血原因，宫腔纱条填塞指征、方法及效果 (本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，并与研究对象签署临床研究知情同意书)。进行接受宫腔纱条填塞时出血量与填塞治疗效果比较。

结果

70例患者全部抢救成功，其中65例(92.86%)宫腔纱条填塞法成功，5例(7.14%)宫腔纱条填塞失败，行子宫切除术。术中出血量与填塞治疗效果比较显示，术中宫腔纱条填塞时出血量与填塞效果密切相关(r＝－0.706，P<0.05)，且填塞时出血量越少，填塞效果越好，差异有显著意义(P<0.05)。

结论

宫腔纱条填塞是一种安全、有效的治疗中央型前置胎盘剖宫产术中大出血的方法。

关键词: 宫腔纱条填塞, 中央型前置胎盘, 产后出血
Objective

To explore the effectiveness of uterine packing in controlling of intractable hemorrhage during cesarean section with central placenta previa.

Methods

This retrospective study was conducted on clinical data of 70 pregnant women who were diagnosed with central placenta previa from May 2005 to March 2010, and uterine packing has been used in cases of massive hemorrhage during cesarean section. Causes of hemorrhage, the indication of uterine packing, uterine packing procedure and effectiveness were analyzed, and the volume of uterine bleeding during packing and effectiveness of uterine packing were compared. Informed consent was obtained from all participates.

Results

All 70 cases were successfully salvaged, in which 65 cases(92.86%) were successfully in controlling of intraoperative bleeding with uterine cavity ribbon gauze packing; in which 5 cases(7.14%)failed and had hysterectomy. The comparison showed that blood loss during packing were closely related to effectiveness of uterine packing (r=-0.706, P<0.05). And the less blood loss when packing, the better effect, there were significant difference(P<0.05).

Conclusion

Uterine packing is a safe and effective technique in controlling of intractable hemorrhage during cesarean section with central placenta previa.

Key words: uterine packing, central placenta previa, postpartum hemorrhage (PPH)
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