安列克联合B-Lynch缝合治疗剖宫产后大出血的效果

Effect of anlieke combined with B-Lynch suture in the treatment of large hemorrhage after cesarean section

目的:探讨安列克(卡前列素氨丁三醇)联合B-Lynch缝合术在剖宫产产后大出血治疗中的应用价值。方法:选取2015年3月至2017年7月剖宫产产后大出血患者82例为研究对象,以随机数字表法分为对照组41例,观察组41例,对照组行卡前列素氨丁三醇联合纱布填塞止血;观察组行卡前列素氨丁三醇联合B-Lynch缝合术止血,观察两组止血效果、子宫切除情况、不同阶段出血量及血小板计数(PLT)、D二聚体(D-D)、C反应蛋白(CRP)变化。结果:观察组止血有效率为97. 56%,同对照组82. 93%比较,显著较高,观察组宫切除率为2. 44%,同对照组14. 63%比较,明显较低,差异有统计学意义(P <0. 05);观察组术中出血量及术后2 h内、24 h内出血量同对照组比较,明显较少,差异有统计学意义(P <0. 05);产前两组患者PLT、D-D、CRP无显著差异(P> 0. 05),产后24 h观察组PLT显著高于对照组,D-D、CRP明显低于对照组,差异有统计学意义(P <0. 05)。结论:卡前列素氨丁三醇联合B-Lynch缝合术治疗剖宫产产后大出血效果显著,可有效降低子宫切除率,且能减少凝血指标及炎性因子波动,值得推广。

Objective： To explore the application value of anlieke（carboprost tromethamine）combined with B-Lynch suture technique in the treatment of postpartum hemorrhage in cesarean section. Methods： 82 cases of postpartum hemorrhage in cesarean section from March 2015 to July 2017 were selected as the research objects and randomly divided into the control group and the observation group, with 41 cases in each group. The patients in the control group were treated with carboprost tromethamine combined with gauze packing to stop bleeding while patients in the observation group were treated with carboprost tromethamine combined with B-Lynch suture technique to stop bleeding. The hemostatic effect, hysterectomy, blood loss in different stages and changes of blood platelet count （PLT）, D-Dimer （D-D） and C-reactive protein （CRP） in two groups were observed. Results： Compared with 82.93 % in the control group, the effective rate of hemostasis in the observation group was 97.56 %, which was significantly higher. The rate of hysterectomy in the observation group was 2.44 %, which was significantly lower than 14.63% of the control group, and the difference was statistically significant （ P 〈0.05）. The amount of bleeding during the operation and the amount of bleeding within 2 h, 24 h after operation in the observation group were significantly less than those in the control group, and the difference was statistically significant （ P 〈0.05）. Before delivery, there was no significant difference in PLT, D-D and CRP between the two groups （ P 〉0.05）, but within 24h after delivery, PLT in the observation group was significantly higher than that in the control group, and D-D and CRP were significantly lower than those in the control group. The difference was statistically significant （ P 〈0.05）. Conclusion： The curative effect of the treatment of carboprost tromethamine combined with B-Lynch suture technique in treatment of postpartum hemorrhage after cesarean section is significant, which can effectively reduce the rate of hysterectomy and reduce the fluctuation of coagulation indexes and inflammatory factors. So it is worthy of promotion.