子宫下段横向缩窄术减少瘢痕子宫剖宫产术中出血量的效果评估(1)
【摘要】 目的：探讨子宫下段横向缩窄术减少瘢痕子宫剖宫产术中出血量的效果。方法：选取本院2015年7月-2016年12月收入院的240例二次剖宫产孕妇，按照随机数字表法分为对照组与治疗组，每组各120例。对照组予以传统方式止血，治疗组在对照组基础上行子宫下段横向缩窄术。观察两组患者的临床治疗效果、手术时间与出血情况。结果：治疗组临床治疗效果明显高于对照组，手术时间短于对照组，术中出血量与术后24 h出血量少于对照组，差异均有统计学意义(P<0.05)。结论：子宫下段横向缩窄术能够有效地减少瘢痕子宫剖宫产术中出血量，具有较高的临床推广价值。
【关键词】 子宫下段； 横向缩窄术； 瘢痕子宫； 剖宫产术中出血量
Transverse Constriction in Lower Uterine Segment to Reduces Amount of Bleeding in Cesarean Section/DU Aiqi，LAI Tingting.//Medical Innovation of China，2018，15(13)：127-130
, http://www.100md.com
【Abstract】 Objective：To explore the effect of transverse constriction in lower uterine segment to reduce amount of bleeding in cesarean section.Method：A total of 240 pregnant women of second time cesarean section in our hospital from July 2015 to December 2016 were randomly divided into control group and treatment group according to table of random numbers，120 cases in each group.The control group was treated with traditional way for hemostasis，the treatment group was treated with transverse constriction in lower uterine segment on the basis of traditional way for hemostasis.The clinical efficacy，operative time and bleeding were observed between the two groups.Result：The clinical effective of the treatment group was obviously higher than that of the control group，operation time of the treatment group was shorter than that of the control group，intraoperative blood loss and postoperative 24 h the bleeding of the treatment group were less than those of the control group，the differences were statistical significance(P<0.05).Conclusion：Transverse constriction in lower uterine segment can effectively reduce the amount of bleeding in the cesarean section of scar uterus and has a high clinical value.
, 百拇医药
【Key words】 lower uterine segment； Transverse constriction； Scarred uterus； Blood loss during cesarean section
First-author’s address：Foshan Sanshui Maternity and Child Care Hospital，Foshan 528000，China
doi：10.3969/j.issn.1674-4985.2018.13.036
隨着全球剖宫产率上升，同时腹腔镜下子宫肌瘤剔除术的广泛开展，我国育龄妇女的瘢痕子宫数量持续攀升[1]。而我国单独二胎政策开放后，瘢痕子宫再次妊娠发生率也随之升高[2]。依据不同文献[3]报道，瘢痕子宫妊娠晚期子宫下段全层厚度范围在1.7～19.2 mm，子宫肌层厚度范围在0.6～9.7 mm。在以往的临床治疗中，医生多采用传统的方式进行止血治疗，虽然能够获得一定的效果，然而患者多出现反复出血的症状，对自身造成较大的不良影响[4]。随着医疗技术的不断发展，目前临床中主要采用子宫下段横向缩窄术进行止血治疗，能够有效地弥补传统方式不足，获得良好的治疗效果[5]。本文将重点探讨子宫下段横向缩窄术减少瘢痕子宫剖宫产术中出血量的效果，现报道如下。
1 资料与方法
1.1 一般资料 选取本院2015年7月-2016年12月收入院的240例因“瘢痕子宫”择期行二次剖宫产孕妇，按照随机数字表法分为对照组与治疗组。纳入标准：(1)符合子宫下段横向缩窄术条件；(2)B超提示Ⅱ级瘢痕。排除标准：(1)排除巨大胎儿、双胎妊娠、前置胎盘患者；(2)患有妊娠合并子宫肌瘤、妊娠期高血压等疾病；(3)凝血功能障碍。告知两组患者及其家属此次研究的目的与方法，并自愿签署知情同意书，同时此研究经伦理委员同意。, http://www.100md.com(杜爱琪 赖婷婷)
【关键词】 子宫下段； 横向缩窄术； 瘢痕子宫； 剖宫产术中出血量
Transverse Constriction in Lower Uterine Segment to Reduces Amount of Bleeding in Cesarean Section/DU Aiqi，LAI Tingting.//Medical Innovation of China，2018，15(13)：127-130
, http://www.100md.com
【Abstract】 Objective：To explore the effect of transverse constriction in lower uterine segment to reduce amount of bleeding in cesarean section.Method：A total of 240 pregnant women of second time cesarean section in our hospital from July 2015 to December 2016 were randomly divided into control group and treatment group according to table of random numbers，120 cases in each group.The control group was treated with traditional way for hemostasis，the treatment group was treated with transverse constriction in lower uterine segment on the basis of traditional way for hemostasis.The clinical efficacy，operative time and bleeding were observed between the two groups.Result：The clinical effective of the treatment group was obviously higher than that of the control group，operation time of the treatment group was shorter than that of the control group，intraoperative blood loss and postoperative 24 h the bleeding of the treatment group were less than those of the control group，the differences were statistical significance(P<0.05).Conclusion：Transverse constriction in lower uterine segment can effectively reduce the amount of bleeding in the cesarean section of scar uterus and has a high clinical value.
, 百拇医药
【Key words】 lower uterine segment； Transverse constriction； Scarred uterus； Blood loss during cesarean section
First-author’s address：Foshan Sanshui Maternity and Child Care Hospital，Foshan 528000，China
doi：10.3969/j.issn.1674-4985.2018.13.036
隨着全球剖宫产率上升，同时腹腔镜下子宫肌瘤剔除术的广泛开展，我国育龄妇女的瘢痕子宫数量持续攀升[1]。而我国单独二胎政策开放后，瘢痕子宫再次妊娠发生率也随之升高[2]。依据不同文献[3]报道，瘢痕子宫妊娠晚期子宫下段全层厚度范围在1.7～19.2 mm，子宫肌层厚度范围在0.6～9.7 mm。在以往的临床治疗中，医生多采用传统的方式进行止血治疗，虽然能够获得一定的效果，然而患者多出现反复出血的症状，对自身造成较大的不良影响[4]。随着医疗技术的不断发展，目前临床中主要采用子宫下段横向缩窄术进行止血治疗，能够有效地弥补传统方式不足，获得良好的治疗效果[5]。本文将重点探讨子宫下段横向缩窄术减少瘢痕子宫剖宫产术中出血量的效果，现报道如下。
1 资料与方法
1.1 一般资料 选取本院2015年7月-2016年12月收入院的240例因“瘢痕子宫”择期行二次剖宫产孕妇，按照随机数字表法分为对照组与治疗组。纳入标准：(1)符合子宫下段横向缩窄术条件；(2)B超提示Ⅱ级瘢痕。排除标准：(1)排除巨大胎儿、双胎妊娠、前置胎盘患者；(2)患有妊娠合并子宫肌瘤、妊娠期高血压等疾病；(3)凝血功能障碍。告知两组患者及其家属此次研究的目的与方法，并自愿签署知情同意书，同时此研究经伦理委员同意。, http://www.100md.com(杜爱琪 赖婷婷)