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目的探讨改良子宫背带式缝合加子宫动脉上行支缝扎在抢救顽固性宫缩乏力性产后出血中的临床实用价值。方法回顾性分析1999年6月～2004年6月运用此术式成功抢救的21例顽固性宫缩乏力性产后出血患者的临床资料,均经保守治疗仍不能控制出血,出血量平均2800(2100～5600)ml。结果21例均手术抢救成功,1～5min内有效止血,保留了子宫及其生理功能。术后发生急性肾衰2例,肺部感染1例,经对症处理治愈。21例均获随访,平均13(7～48)月,月经恢复无异常。结论改良子宫背带式缝合加子宫动脉上行支缝扎术是抢救顽固性宫缩乏力性产后大出血的有效措施之一,对产后月经恢复无影响。
Objective To investigate the clinical value of improved uterine suture straps and uterine artery ligation in the treatment of intractable uterine atony postpartum hemorrhage. Methods The clinical data of 21 patients with intractable uterine atony postpartum hemorrhage who were treated successfully by this technique from June 1999 to June 2004 were retrospectively analyzed. All of them were uncontrollable bleeding after conservative treatment. The average amount of bleeding was 2800 (2100 ~ 5600) ml. Results All the 21 cases were successfully rescued by surgery, and effective hemostasis was achieved within 1 ~ 5 minutes, retaining the uterus and its physiological functions. Postoperative acute renal failure in 2 cases, 1 case of pulmonary infection, cured by symptomatic treatment. Twenty-one patients were followed up for an average of 13 months (range, 7 to 48 months). Menstrual recovery was normal. Conclusion Improved uterine suture suture plus uterine artery ligation is an effective method of rescuing intractable uterine inertia postpartum hemorrhage, and has no effect on postpartum menstrual recovery.