产后出血最佳治疗方案研究

Research of optimal methods for the treatment of postpartum hemorrhage

目的探讨可应用于产后出血的最佳治疗方案。方法对2011年2月至2013年2月于陕西省延安市宝塔区妇幼保健院接受治疗的96例产后出血患者的病历资料进行回顾性分析。根据治疗方案的不同,将患者分为宫缩剂组、宫腔填塞组、背带式缝合组及子宫切除组,每组患者24例。采用统计学方法比较各研究组的起效时间、出血量、止血率及总有效率。结果各研究组患者出血量比较差异有统计学意义(P<0.05)。子宫切除组、宫腔填塞组总有效率高于宫缩剂组合背带式缝合组,但起效时间晚于后两者(P<0.05)。结论在产后出血不同治疗方案中,背带式缝合手术难度较大,耗时较长,不建议使用;宫腔填塞止血操作简便,疗效显著,值得推广应用;若产妇产后出血病情严重,可酌情考虑采用子宫切除治疗。

Objective To explore the optimal methods for the treatment of postpartum hemorrhage .Methods Clinical data of 96 patients with postpartum hemorrhage ,treated in Maternal and Child Health Care Hospital of Baota District during Feb .2011 and Feb .2013 ,were retrospectively analyzed .According to therapeutic methods ,all patients were divided into uterotonic group ,intrauterine packing group ,B-lynch sutural group and hysterectomy group ,with 24 patients in each group .Effecting time ,bleeding amount ,hemostasis rate and total effective rate were compared be-tween all groups .Results There was significant difference of bleeding amount between all groups （P〈0 .05） .The total effective rates of intrauterine packing group and hysterectomy group were obviously higher than uterotonic group and B-lynch sutural group ,while effecting time of the former two groups was longer than the later two groups （P〈0 .05） .Conclusion Among all of the four methods for the treatment of postpartum hemorrhage ,B-lynch sutural surgery could be difficult for operation and time consuming ,intrauterine packing could simple for operation and sig-nificant efficient ,and hysterectomy should be only performed when pathogenetic condition of patents are severe .