子宫卵巢动脉吻合支结扎术在剖宫产术中子宫大出血应用体会.doc

子宫卵巢动脉吻合支结扎术在剖宫产术中子宫大出血应用体会 　　doi：10.3969/j.issn.1007-614x.2014.10.35 摘 要 目的：探讨子宫卵巢动脉吻合支结扎术在剖宫产术中子宫出血的应用价值。方法：收治剖宫产术中因出血不止辅以结扎子宫卵巢动脉吻合支患者15例，并对结果进行分析。结果：施行该方法后，均达到止血效果，无再次出血病例，无1例子宫切除，随访未发现并发症。结论：剖宫产术中大出血经一般处理及结扎双侧子宫动脉上行支无效时，辅以结扎双侧或单侧子宫卵巢动脉吻合支，可达到止血效果，保留子宫，且无并发症。 关键词 子宫卵巢动脉吻合支结扎 剖宫产 大出血 Application experience of ligation of anastomotic branch of uterine and ovarian artery for uterine bleeding in cesarean section Zhao Guizhen，Cui Yuping Department of Obstetrics and Gynecology，the People’s Hospital of Huanxian，Qingyang area，Gansu 745700 Abstract Objective：To explore the value of application of ligation of anastomotic branch of uterine and ovarian artery for uterine bleeding in cesarean section.Methods：15 patients with ligation of anastomotic branch of uterine and ovarian artery for uterine bleeding in cesarean section were selected，we analyzed the results of them.Results：After the implementation of the method，all of the patients were reached the hemostatic effect，there was no re bleeding and hysterectomy cases，there was no complications after follow-up.Conclusion：When it is ineffective of uterine bleeding in cesarean section treated with general processing and bilateral ascending uterine arteries ligation，assisted with anastomotic branch ligation of bilateral or unilateral uterine and ovarian arteries can achieve hemostasis，this method can keep the uterus and no complications. Key words Ligation of Anastomotic branch of uterine and ovarian artery；Cesarean section；Bleeding 产后出血是产科医生在临床工作中经常见到的一类分娩期并发症，其治疗效果往往不理想，严重者常会导致产妇死亡，对家庭和社会造成沉重的负担。随着社会的发展，医疗技术也在不断的提高，我国孕产妇的死亡率同以前相比，有着显著的下降，但是在导致产妇死亡的众多原因中，产后出血仍是最主要因素。目前，我国的剖宫产率有着显著的升高，虽然手术设备和技术有着相应的提升，但是在剖宫产时发生大出血的总例数还是有所上升，所以，在手术中，我们必须提高警惕，及时有效地处理在术中、术后所发生的大出血，尽最大努力保留产妇子宫，这对降低产妇死亡率、维护产妇身心健康极为关键。近3年来，我院在处理剖宫产术中因宫缩乏力、胎盘因素、妊娠期高血压疾病引起的难以控制的子宫出血中，辅以结扎子宫卵巢动脉吻合支，取得良好的效果，保全了产妇子宫，现报告如下。 资料与方法 2009年1月-2013年5月收治剖宫产术中因出血不止辅以结扎子宫卵巢动脉吻合支患者15例，年龄26～38岁，孕周38～42周，初产妇9例，经产妇6例。剖宫产指征：巨大儿4例，头位难产3例，臀位1例、胎儿窘迫3例，前置胎盘3例、重度