双侧对侧宫颈钳在产后出血中的新临床应用：一项回顾性队列研究。
The new clinical application of bilateral-contralateral cervix clamp in postpartum hemorrhage: a retrospective cohort study.
机构信息
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China.
出版信息
BMC Pregnancy Childbirth. 2021 Jan 13;21(1):53. doi: 10.1186/s12884-020-03518-2.
BACKGROUND
To assess the efficacy and safety of bilateral-contralateral cervix clamp firstly applied in postpartum hemorrhage caused by uterine tony of lower segment.
METHODS
Totally 47 pregnant women with postpartum hemorrhage secondary to lower uterine segment atony in vaginal delivery or after caesarean delivery were included from March 1, 2020 to May 31, 2020. According to patient's informed consent, 22 women accepted cervical clamp to treat and 25 only used uterotonics in control group. Then hemostatic efficacy and safety of bilateral-contralateral cervix clamp were assessed by retrospective analysis.
RESULTS
It was found that mean blood loss in clamp group was much less during vaginal delivery (656.2±72.79 g vs 811.8±86.07 g, p = 0.001) or after caesarean delivery (42.8±6.60 g vs 126.3±86.97 g, p = 0.007), and incidence of uterotonic repeated usage (81.8% vs 36, 18.2% vs 64%, p = 0.001) or side effect (18.2% vs 48.0%, p = 0.031) appeared less than control group, but there was no statistical differences on hospital stay (4.1±1.57 days vs 3.8±1.61 days, p = 0.535), hemoglobin (119±4.10 g vs 121.4±4.19 g, p = 0.058), blood transfusion (9.1% vs 12%,p = 0.746), surgical procedures (4.5% vs 4.0%, p = 0.93), also no clamp complications occurred.
CONCLUSIONS
The bilateral-contralateral cervix clamp was effective and safe, this new technique could be a complementary treatment for postpartum hemorrhage.
背景
评估双侧-对侧宫颈钳首先应用于下段子宫乏力引起的产后出血的疗效和安全性。
方法
选取 2020 年 3 月 1 日至 2020 年 5 月 31 日因阴道分娩或剖宫产术后下段子宫乏力导致产后出血的 47 例孕妇，根据患者知情同意，22 例接受宫颈钳治疗，25 例仅在对照组使用宫缩剂。然后通过回顾性分析评估双侧-对侧宫颈钳的止血效果和安全性。
结果
发现钳夹组阴道分娩时平均出血量明显减少（656.2±72.79g 比 811.8±86.07g，p=0.001）或剖宫产时（42.8±6.60g 比 126.3±86.97g，p=0.007），宫缩剂重复使用的发生率（81.8%比 36%，18.2%比 64%，p=0.001）或副作用（18.2%比 48.0%，p=0.031）低于对照组，但住院时间（4.1±1.57 天比 3.8±1.61 天，p=0.535）、血红蛋白（119±4.10g 比 121.4±4.19g，p=0.058）、输血（9.1%比 12%，p=0.746）、手术方式（4.5%比 4.0%，p=0.93）无统计学差异，也无钳夹并发症发生。
结论
双侧-对侧宫颈钳有效且安全，这项新技术可为产后出血提供补充治疗。
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