改良B-Lynch缝合术联合卡前列素氨丁三醇治疗宫缩乏力性产后出血的疗效观察

Observation on Efficacy of Improved B-lynch Sutura Combined with Carboprost Tromethamine in Treatment of Postpartum Hemorrhage Caused by Uterine Inertia

目的:改良B-Lynch缝合术联合卡前列素氨丁三醇治疗宫缩乏力性产后出血的控血效果及安全性。方法:纳入2011年5月—2015年5月收治的102例剖宫产术中发生宫缩乏力的患者,以随机数字表法分为2组。2组患者均给予传统治疗方案,对照组患者(51例)加用卡前列素氨丁三醇,观察组患者(61例)则加用改良B-Lynch缝合术联合卡前列素氨丁三醇,对比2组患者的疗效及不良反应发生情况。结果:观察组患者平均手术时间为(165.3±33.2)min,明显低于对照组的(226.5±25.4)min,差异有统计学意义(P<0.05);观察组患者平均术中出血量为(1 180.3±33.7)ml,明显低于对照组的(1 683.6±23.9)ml,差异有统计学意义(P<0.05);2组患者平均术后24 h出血量的差异无统计学意义(P>0.05);观察组患者术后2 h出血率、子宫切除率及止血有效率均明显高于对照组,差异均有统计学意义(P<0.05);观察组患者腹痛、肠梗阻、产褥病的发生率均明显低于对照组,差异有统计学意义(P<0.05),2组患者均未发生肠黏连的并发症。结论:剖宫产术后出现宫缩乏力性产后出血患者应用改良B-Lynch缝合术联合卡前列素氨丁三醇的控血效果显著,并安全性较高,值得推广。

OBJECTIVE： To investigate the efficacy and safety of improved b-lynch sutura combined with carboprost tromethamine in treatment of postpartum hemorrhage caused by uterine inertia. METHODS： 102 patients with postpartum hemorrhage caused by uterine inertia admitted from Apr. 2011 to Apr. 2015 were selected to bedivided into two groups. Both groups were treated with traditional treatment,and the control group（ 51 cases）additionally received carboprost tromethamine,the observation group（ 61 cases） were additionally given improved blynch sutura combined with carboprost tromethamine. The efficacy and occurrence of adverse drug reactions were compared between two groups. RESULTS： The mean operative time of observation group was（ 165. 3 ± 33. 2） min,significantly shorter than that of control group [（ 226. 5 ± 25. 4） min],with statistically significant difference（ P〈0. 05）. The mean blood loss amount of observation group was（ 1 180. 3 ± 33. 7） ml,significantly lower than that of control group [（ 1 683. 6 ± 23. 9） ml],with statistically significant difference（ P〈0. 05）. There was no statistical significance between two groups in mean blood loss amount of postoperative 24 h（ P〉0. 05）. After treatment,the bleeding rate of postoperative 2 h,hysterectomy rate and hemostatic efficiency of observation group were significantly higher than that of control group,with statistically significant difference（ P〈0. 05）. The incidence of stomachache,ileus and puerperalism of observation group were significantly lower than that of control group,with statistically significant difference（ P〈0. 05）. There was no complications of intestinal adhesion in both groups. CONCLUSIONS：The efficacy of improved b-lynch sutura combined with carboprost tromethamine in treatment of postpartum hemorrhage caused by uterine inertia is remarkable,with high safety,which is worthy of application and promotion.