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我们对6例剖宫产术中常规治疗无效的严重出血患者,在输液、补血、扩容等同时结扎子宫动脉上行支与卵巢动脉子宫支,取得了满意效果。 临床资料:患者年龄26～32岁,平均28.5岁。其中胎盘早剥致子宫卒中2例,子宫收缩乏力3例,胎盘部分植入1例。出血量1800～3500ml,平均2600ml。6例均行子宫动脉上行支与卵巢动脉子宫支结扎,其中1例胎盘部分植入患者同时用刮匙清理宫壁,肠线“8”字缝合。 手术方法:①结扎子宫动脉上行支:术者以左手垫在左侧子宫下段后壁处,用大弯无创伤缝合针自子宫横切口下子宫肌层(子宫边缘1～1.5cm处)进针(不穿到子宫内膜),在子宫血管外1cm处出针,然后用无创伤缝合针(亦可用大弯针,7号丝线或0号肠线)结扎。若结扎右侧子宫动脉上行支,亦将右手置于子宫右后壁,但从子宫血管外侧进针,右侧肌层出针。②结扎卵巢动脉子宫支:对子宫体部出血和结扎子宫动脉上行支后欲保留生育机能者可行双
We have six cases of severe bleeding in cesarean section routine treatment ineffective, infusion, blood, expansion, and the ligation of the uterine branch of the uterine artery and ovarian artery branch, and achieved satisfactory results. Clinical data: Patients aged 26 to 32 years, mean 28.5 years old. Including placental abruption in 2 cases of uterine stroke, uterine inertia in 3 cases, part of the placenta implanted in 1 case. Bleeding 1800 ~ 3500ml, an average of 2600ml. All 6 cases underwent uterine branch ligation of uterine artery and ovarian artery. One of the placenta was partially implanted into the wall of the uterus, while the “8” suture was sutured. Surgical methods: ① Uterine artery ligation ligation: surgery to the left hand pad in the left uterine wall at the posterior wall, with a large curved non-invasive suture needle from the uterine incision under the myometrium (uterine edge 1 ~ 1.5cm Department) into the needle (Do not wear to the endometrium), in the uterine vascular 1cm out of the needle, and then with non-invasive suture needle (also available loach, No. 7 silk or 0 gut) ligation. If the ligation of the right uterine artery branch, right hand will also be placed in the right posterior wall of the uterus, but the needle into the uterine blood vessels outside the right side of the muscle out of the needle. ② ligation of the ovarian artery uterus branch: on the uterine body bleeding and ligation of the uterine artery upstream branch to retain the function of fertility are feasible