宫缩乏力性产后出血患者的预防和治疗

Prevention and Treatment of Patients with Uterine Atony Postpartum Hemorrhage

目的:探讨宫缩乏力性产后出血的预防和治疗方法。方法:选择我院2009年1月至2012年12月收治的经产后出血预测评分表测试分数≥5分的36-44孕周产妇68例,将其随机分为观察组与对照组各34例,两组产妇产前均根据产后出血预测评分来进行针对性的预防措施,在生产过程中或产后发生出血的患者均联合使用缩宫素和米索前列醇,按摩子宫,行子宫动脉结扎,经观察证实无效后,对照组采用B-Lynch缝线术,观察组采用我院改良后B-Lynch缝线术,比较两组患者的止血时间和效果。结果:对照组发生产后出血12例(产后出血率35.3%),观察组11例(产后出血率32.4%),两组比较无显著性差异(P﹥0.05)。观察组采用改良的B-Lynch缝线术方法进行止血,其24h内累计出血量低于对照组,但是两组比较差异无统计学意义(P﹥0.05)。结论:宫缩乏力性产后出血患者应积极预防、采取各项治疗措施减少出血量。

Objective： To investigate uterine atony postpartum hemorrhage prevention and treatment. Method：By ratings table test scores 〉I 5 points, 36 to 44 weeks gestation maternal postpartum hemorrhage predict. From January 2009 to December 2012, 68 cases we, randomly divided into observation group and control group, each with 34 cases, maternal prenatal are rated according to the prediction of postpartum hemorrhage targeted prevention measures in the production process or postpartum bleeding patients with oxytocin and misoprostol combined use massage the uterus, uterine artery ligation, proved to be ineffective were ob- served in the control group using a B-Lynch suture technique, B-Lynch suture technique in the observation group were treated in our hospital improved hemostasis time and effect. Result： Postpartum hemorrhage oc- curred in 12 patients （35.3%） of control group, 11 cases （32.4%） in the observ/ttion group, which showed no significant difference （P〉 O. 05 ）. The observation group using modified B-Lynch suture surgery method to stop the bleeding, the cumulative amount of bleeding was tess in observation group than the control group, but the difference was not statistically significant （P〉 0.05 ）. Conclusion： Contractions with postpartum bleeding patients should actively prevent, to reduce the amount of bleeding