欣母沛联合手术治疗产后出血的临床应用

Clinical application of Hemabate combined with operation for treating postpartum hemorrhage

目的比较子宫动脉结扎术、B-lynch术、欣母沛(通用名:卡前列素氨丁三醇注射液)与子宫动脉结扎术、B-lynch术、髂内动脉结扎术治疗产后出血的疗效。方法随机将产后出血患者分为两组,行子宫动脉结扎术、B-lynch术、欣母沛治疗38例,行子宫动脉结扎术、B-lynch术、髂内动脉结扎术22例,并进行比较分析。结果两组患者手术时间、术中出血量、术后病率及肛门排气时间比较,差异有统计学意义(P<0.05);两组患者术后2、24 h出血量,产后出血,术后疼痛评分,下床活动时间,住院时间,切口愈合时间,术后妊娠率,月经恢复,子宫复旧,子宫卵巢血供等方面比较,差异均无统计学意义(P>0.05)。结论子宫动脉结扎术、B-lynch术、欣母沛与子宫动脉结扎术、B-lynch术、髂内动脉结扎术比较手术时间短,术中出血少,术后恢复快,术后病率少。欣母沛联合治疗产后出血效果显著,值得临床推广应用。

Objective To compare the clinical effects between the combination of uterine artery ligation,B-Lynch opeartion and Hemabate with the combnation of uterine artery ligation,B-Lynch opeartion and ligation of internal iliac artery for treating postpartum hemorrhage. Methods 38 cases of postpartum hemorrhage were randomly divided into two groups. 38 cases were treated by the uterine artery ligationt, B-Lynch operation and Hemabate and 22 cases were treated by uterine artery ligation, B-Lynch operation and ligation of internal iliac artery. Results There were statistical differences in the operating time,intraoperative bleeding volume, postoperative morbidity and anal exhaust time between two groups （P〈0.05）. But there were no statistical differences in the bleeding volume at postoperative 2,24 h,postpartum hemorrhage,VAS scores,time to get out of bed,wound healing time, hospitalization time, menstrual recovery, postoperative pregnancy rate, involution of uterus, uterine and ovarian blood supply between two groups （P〉0.05）. Conclusion The combination of uterine artery ligation, B-Lynch operation and Hemabate is superior to the combination of uterine artery ligation, B-Lynch operation and ligation of internal iliac artery in the treatment of postpartum hemorrhage with the advantages of short opertion time,less intraoperative bleeding,rapid postoperative recovery and low postoperative morbidity rate. Hemabate combination therapy has sgnificant efffects for treating postpartum hemorrhagew and is worthy of generalization in clinic.