B-Lynch缝合术联合卡前列素氨丁三醇预防高危产妇剖宫产术中及产后出血的疗效观察

Observation on the curative effect of B-Lynch suture combined with carboprost tromethamine in prevention of intraoperative hemorrhage and postpartum hemorrhage in high-risk pregnant women undergoing cesarean section

目的观察B-Lynch缝合术联合卡前列素氨丁三醇预防高危产妇剖宫产术中及产后出血的疗效,为高危产妇剖宫产术中及产后出血的治疗提供理论依据。方法选取2011年3月-2017年3月在四川省盐边县人民医院产科住院分娩的80例高危产妇为研究对象,均行剖宫产术终止妊娠,根据就诊时间先后将研究对象分为缝合组与对照组,每组各40例。所有产妇均在胎儿娩出时立即给予缩宫素,对照组给予卡前列素氨丁三醇治疗,缝合组在对照组基础上给予B-Lynch缝合术治疗。比较两组产妇出血量、住院时间、输血与子宫切除情况、产后恶露持续时间、月经恢复情况及术后并发症发生率的差异。结果缝合组术中出血量、术后24h出血量、住院时间显著低于对照组(P<0. 05)。两组产妇均未行子宫切除术。两组产后恶露持续时间、首次月经恢复时间、月经周期比较差异无统计学意义(P>0. 05)。缝合组剖宫产术后并发症总发生率显著低于对照组(P<0. 05)。结论 B-Lynch缝合术联合卡前列素氨丁三醇可以减少高危产妇剖宫产术中与产后出血量,止血效果显著,且能保留产妇子宫,有利于产妇剖宫产术后恢复。

Objective To observe the curative effect of B-Lynch suture combined with carboprost tromethamine in prevention of intrao- perative hemorrhage and postpartum hemorrhage in high-risk pregnant women undergoing cesarean section, provide a theoretical basis for treatment of intraoperative hemorrhage and postpartum hemorrhage. Methods From March 2011 to March 2017, 80 high-risk pregnant women were selected from Department of Obstetrics in Yanbian County People＇s Hospital, then cesarean section was performed. All the women were divided into suture group and control group according to the time of admission, 40 women in each group. Oxytocin was given im- mediately after delivery of the baby. The women in control group were treated by carboprost tromethamine, and the women in suture group were treated by B-Lynch suture combined with carboprost tromethamine. The amounts of blood loss, hospitalization time, blood transfusion and uterine excision, duration time of postpartum lochia, menstrual recovery, and incidence rates of complications after cesarean section in the two groups were compared. Results The amounts of intraoperative hemorrhage and postoperative hemorrhage at 24 hours after cesarean section, hospitalization time in suture group were statistically significantly lower than those in control group （P〈0. 05） . The women in the two groups were not treated by hysterectomy. There was no statistically significant difference in duration time of postpartum lochia, time of menstrual recovery at the first time, and menstrual cycle between the two groups （P〉0. 05） . The total incidence rate of complications after cesarean section in suture group was statistically significantly lower than that in control group （P〈0.05） . Conclusion B-Lynch suture combined with carboprost tromethamine can reduce the amounts of intraoperative hemorrhage and postpartum hemorrhage in high-risk preg- nant women undergoing cesarean section, the effect of hemostasis is significant, the therapy can reserve uterus of women, which is good for maternal recovery after cesarean section.