一次性宫腔压迫双球囊联合卡前列素氨丁三醇防治前置胎盘伴胎盘植入产后出血的效果

Prevention and Treatment of Postpartum Hemorrhage of Placenta Previa with Placenta Accreta by One-time Uterine Compression Double Balloon Combined with Carboprost Tromethamine

目的探析前置胎盘伴胎盘植入产妇产后出血应用压迫止血联合药物止血的防治效果。方法选取二甲医院45例前置胎盘伴胎盘植入产妇,随机分为对照组(23例)和观察组(22例)。两组均给予剖宫产手术,并给予简单止血操作;对照组联合卡前列素氨丁三醇止血,观察组在对照组基础上联合一次性宫腔压迫双球囊,观察两组产妇围手术期出血、风险事件发生及手术相关指标情况。结果观察组风险事件发生率(产后大出血、子宫切除、Blynch缝合)均明显低于对照组(P<0.05);而产褥感染发生率两组无统计学差异(P>0.05)。观察组的围手术期出血量(术中、产后2 h、24 h)均明显低于对照组(P<0.05);观察组的各项手术相关指标(手术时间、止血时间、住院时间)均明显短于对照组(P<0.05)。结论应用压迫止血(一次性宫腔压迫双球囊)联合药物止血(卡前列素氨丁三醇)对于前置胎盘伴胎盘植入产后出血的防治效果显著,可以有效降低围手术期出血量及风险事件发生率,有利于患者术后恢复,值得临床推广。

Objective To explore the prevention and treatment effect of compression hemostasis combined with drug hemostasis on postpartum hemorrhage of placenta previa with placenta accreta.Methods Forty-five cases of placenta previa with placenta accreta in the second class hospital were randomly divided into control group(23 cases)and observation group(22 cases).The two groups were given cesarean section,and given simple hemostasis operation;the control group combined with carboprost tromethamine hemostasis,the observation group on the basis of the control group combined with one-time uterine compression double balloon,to observe the two groups of maternal perioperative bleeding,risk events and operation related indicators.Results The incidence of risk events(postpartum hemorrhage,hysterectomy,blynch suture)in the observation group was significantly lower than that in the control group(P<0.05),while the incidence of puerperal infection between the two groups had no statistical difference(P>0.05).The perioperative blood loss(intraoperative,postpartum 2 h,24 h)of the observation group was significantly lower than that of the control group(P<0.05).The operation related indexes(operation time,hemostasis time,hospitalization time)of the observation group were significantly shorter than those of the control group(P<0.05).Conclusion The application of compression hemostasis(one-time uterine compression double balloon)combined with drug hemostasis(carboprost tromethamine)has a significant effect on the prevention and treatment of postpartum hemorrhage of placenta previa with placenta accreta,which can effectively reduce the amount of bleeding and the incidence of risk events,which is conducive to the recovery of patients after operation,and is worthy of clinical promotion.