子宫背带式缝合术联合卡前列素氨丁三醇注射液对剖宫产宫缩乏力产后出血的临床疗效分析

Clinical analysis of uterine parceled suture combined with carboprost tromethamine injection for postpartum hemorrhage caused by uterine inertia in cesarean section

目的 分析剖宫产宫缩乏力产后出血应用子宫背带式缝合术联合卡前列素氨丁三醇注射液治疗的临床疗效及并发症。方法 选取2017年1月至2018年5月在本院经剖宫产分娩所致宫缩乏力产后出血的128例患者临床资料,按不同治疗方案分2组,每组64例,对照组行子宫背带缝合术+缩宫素治疗,观察组行子宫背带缝合术+卡前列素氨丁三醇治疗,比较两组止血效果、产后出血量及并发症等情况。结果 观察组止血总有效率95.31%比对照组81.25%高(P<0.05);观察组产后2 h、24 h出血量[(274.18±56.18)ml、(314.57±59.12)ml]及总出血量[(513.20±81.22)ml]均比对照组少(P<0.05);观察组、对照组治疗后HR、SBP、DBP及MAP均有所下降(P<0.05),但组间差异无统计学意义(P >0.05)。结论 剖宫产宫缩乏力产后出血应用子宫背带式缝合术联合卡前列素氨丁三醇注射液治疗减少产后出血量,止血效果显著,且能控制血流动力学稳定,不易引起并发症、不良反应,安全有效。

Objective To analyze the clinical efficacy and complications of uterine parceled suture combined with carboprost tromethamine injection for postpartum hemorrhage caused by uterine inertia in cesarean section.Methods The clinical data of 128 patients with postpartum hemorrhage caused by uterine inertia in cesarean section in our hospital between January 2017 and May 2018 were selected.According to the different treatment plans,the patients were divided into 2 groups,with 64 cases in each group.The patients in the control group were treated with uterine parceled suture and oxytocin,while the patients in the observation group were treated with uterine parceled suture and carboprost tromethamine injection.The hemostatic effect,volume of postpartum bleeding,and complications were compared between the two groups.Results The total effective rate of hemostasis was 95.31%in the observation group,higher than that in the control group(81.25%)(P<0.05);the postpartum 2 h and 24 h bleeding volume and the total bleeding volume in the observation group were respectively(274.18±56.18)ml,(314.57±59.12)ml,and(513.20±81.22)ml,all less than those in the control group(P<0.05).After treatment,the HR,SBP,DBP,and MAP in both two groups all decreased(P<0.05),but there were no statistically significant differences between the two groups(P >0.05).Conclusion Uterine parceled suture combined with carboprost tromethamine injection is safe and effective in the treatment of postpartum hemorrhage caused by uterine inertia in cesarean section,which can help to reduce postpartum hemorrhage,produce significant effect on hemostasis,and stabilize haemodynamics,without increasing the incidence of complications.