导尿管球囊压迫加卡前列素氨丁三醇在中央型前置胎盘剖宫产术中的应用

Application of oppressing with catheter balloon and carboprost tromethamine to prevent hemorrhage caused by central placenta previa during cesarean

目的探讨导尿管球囊压迫加卡前列素氨丁三醇对中央型前置胎盘剖宫产术中大出血的治疗效果。方法对22例使用导尿管球囊压迫加卡前列素氨丁三醇治疗的中央型前置胎盘剖宫产术中大出血患者临床资料进行回顾性分析。结果22例患者中，17例出血量〈2000ml，均获成功，24h后球囊经阴道顺利取出，无一例感染或晚期产后出血发生；3例因胎盘完全植入，出血量2000—3000ml而行子宫动脉结扎术；1例因术后持续阴道流血行子宫动脉栓塞术；1例出血量达4000ml，发生弥散性血管内凝血行子宫切除。无死亡发生。22例患者术后常规使用广谱抗生素3～7d，均未发现切口感染、盆腔感染或晚期产后出血。结论导尿管球囊压迫加卡前列素氨丁三醇是治疗中央型前置胎盘术中大出血的有效方法。

Objective To study the effect of oppressing with catheter balloon and carboprost trometharnine to prevent hemorrhage caused by central placenta previa during cesarean. Methods The clinical data of 22 cases oppressing with catheter balloon and earboprost tromethamine to prevent hemorrhage caused by central placenta previa during cesarean were analyzed retrospectively. Results Among of 22 cases, 17 patients succeeded in haemostasis 〈2 000 ml. Catheter balloon was took out after 24 h. No infection and late postpartum hemorrhage.There were 3 uterine artery ligation because of placenta implantation with haemostasis 2 000 -3 000 ml,1 uterine artery embolization, 1 hysterectomy with haemostasis 4 000 ml because of disseminated intravaseular coagulopathy and no maternal died. The patients were given postoperative routine antibiotics for 3 -7 d, no infection and late postpartum hemorrhage. Conclusion Oppressing with catheter balloon and carboprost tromethamine is an effective measure to treat hemorrhage caused by central placenta previa during cesarean.