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剖宫产术中临时子宫动脉结扎术预防出血的效果。

The Efficiency of Temporary Uterine Artery Ligation on Prevention of the Bleeding in Cesarean Section.

机构信息

University of Health Sciences, Trabzon Kanuni Health Practice and Research Center, Trabzon, Turkey.

University of Health Sciences, Somalia Mogadishu Recep Tayyip Erdogan Health Practice and Research Center, Mogadishu, Somalia.

出版信息

Gynecol Obstet Invest. 2021;86(6):486-493. doi: 10.1159/000519370. Epub 2021 Oct 29.

Abstract

OBJECTIVE

We aimed to evaluate the effect of temporary ligation of the uterine artery on postpartum bleeding during uncomplicated cesarean section.

DESIGN

This was a prospective, randomized, and controlled study. We recruited a total of 200 patients, including 100 cases and 100 controls.

METHODS

The bilateral uterine artery was temporarily clamped 2 cm below the uterine incision in the study group and compared with controls. Patient demographics, the amount of intraoperative bleeding, the duration of the operation, the closure time of the uterine incision, the need for additional uterotonics, the need for additional sutures, and the hemoglobin values before and after birth were assessed.

RESULTS

The mean value of the amount of bleeding in the clamped and control groups was 267.3 ± 131.8 mL and 390.2 ± 116.4 mL, respectively. The amount of bleeding was significantly decreased for clamped group (p < 0.001). A significant reduction occurred in the results of pre- and postoperative values of hemoglobin and hematocrit difference, operation duration, and the closing time of the uterine incision in the experimental group which has temporary uterine artery clamping.

LIMITATIONS

The cases of recurrent cesareans were not included in this study.

CONCLUSION

Temporary uterine artery ligation can be used to reduce the amount of bleeding during uncomplicated cesarean delivery and prevent postpartum hemorrhage.

摘要

目的

评估在简单剖宫产术中临时结扎子宫动脉对产后出血的影响。

设计

这是一项前瞻性、随机对照研究。我们共招募了 200 名患者,包括 100 例病例和 100 例对照。

方法

研究组在子宫切口下方 2cm 处暂时夹闭双侧子宫动脉,并与对照组进行比较。评估患者的人口统计学特征、术中出血量、手术时间、子宫切口关闭时间、是否需要额外的子宫收缩剂、是否需要额外缝合以及分娩前后的血红蛋白值。

结果

夹闭组和对照组的平均出血量分别为 267.3±131.8mL 和 390.2±116.4mL,夹闭组的出血量明显减少(p<0.001)。实验组(行临时子宫动脉夹闭术)的血红蛋白和血细胞比容差值、手术时间和子宫切口关闭时间的术前和术后值均显著降低。

局限性

本研究未包括复发性剖宫产病例。

结论

在简单剖宫产术中临时结扎子宫动脉可以减少出血量,预防产后出血。

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