宫腔纱条填塞治疗前置胎盘大出血的疗效分析

Clinical effect of modified intrauterine packing on hemorrhage in patients with placenta praevia

目的探讨米索前列醇联合改良宫腔纱条填塞治疗前置胎盘剖宫产大出血的临床效果。方法将前置胎盘行剖宫产术中大出血的患者86例，随机分为观察组和对照组，每组各43例。对照组采用缩宫素、按摩子宫等常规治疗方法；观察组在此基础上给予米索前列醇联合宫腔纱条填塞治疗。比较分析两组产妇术中、术后2h、术后24h的出血量及产后出血率。结果观察组产妇术中、术后2h、术后24h的出血量均显著低于对照组，差异均有统计学意义（t分别为7．81、12．17、11．77．均P＜0．05）；观察组产后出血发生率为4．7％，对照组产后出血发生率为18．6％，两组比较差异有统计学意义（X2=4．07，P〈0．05）。结论米索前列醇联合改良宫腔纱条填塞治疗前置胎盘安全有效，可有效控制出血，减少出血量及并发症。

Objective To explore the clinical effect of misoprostol combined with modified intrauterine packing in treating hemorrhage of cesarean section in patients with placenta praevia. Methods Totally 86 patients with placenta praevia performing cesarean section were randomly divided into two groups. The control group （n = 43） was given regular treatment such as oxytocin and uterus massage, and the observation group （ n = 43） was additionally given misoprostol and modified intrauterine packing. The blood loss at operation, 2h, 24h after operation and the incidence of postpartum hemorrhage of two groups were observed and analyzed. Results The blood loss at operation, 2h and 24h after operation in observation group were significantly less than those in control group （t value was 7.81, 12.17 and 11.77, respectively, all P 〈 0.05 ）. The incidence of postpartum hemorrhage in observation group and control group was 4.7% and 18.6% , respectively, and the difference was statistically significant （X2 = 4.07, P 〈 0.05 ）. Conclusion Misoprostol combined with modified intrauterine packing is effective and sale in treating hemorrhage of cesarean section in patients with placenta praevia, and it can contribute to control bleeding and reduce blood loss and complications.