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目的:对比碘伏纱条宫腔填塞法及双侧子宫动脉上行支结扎法在前置胎盘剖宫产术中的止血效果。方法:回顾性分析因前置胎盘231例行剖宫产术中两种止血方法的效果及切口愈合情况,并分析两种止血方法中失败原因。结果:对边缘性前置胎盘或中央性前置胎盘子宫动脉结扎组术中出血量少于宫腔填塞组,对中央性前置胎盘子宫动脉结扎组术后出血量少于宫腔填塞组。宫腔填塞失败原因为子宫体较大,肌纤维受损,收缩不良;子宫动脉上行支结扎失败原因为子宫下段创面活动性出血,联合局部缝扎及宫腔填塞可有效止血。结论:临床治疗中双侧子宫动脉结扎法更优,必要时可联合宫腔填塞法。
OBJECTIVE: To compare the hemostatic effects of iodoform gauze intrauterine packing and bilateral uterine artery ligation in the placenta previa. Methods: The effects of two hemostasis methods and incision healing in 231 cesarean section patients with placenta previa were retrospectively analyzed. The causes of failure in the two hemostatic methods were analyzed. Results: The amount of blood loss in the marginal placenta previa or central placenta previa was less than that in the uterine cavity embolization group. The bleeding volume in the central placenta previa was less than that in the uterine cavity packing group. The reasons for the failure of uterine cavity packing for the larger uterus, muscle fiber damage, poor contraction; uterine artery ligation due to unsuccessful ligation of the lower uterine wound active bleeding, combined with local suture and intrauterine packing can effectively stop bleeding. Conclusion: Bilateral uterine artery ligation in clinical treatment is superior, if necessary, combined with intrauterine packing.