Bakri子宫填塞球囊导管和胎盘剥离面子宫局部缝合分别联合药物治疗在预防前置胎盘产后出血中的应用对比

Comparison of the Application of the Drug Therapy Combined with Bakri Uterine Stuffing Balloon Catheter and Placental Stripping Surface by Local Suture Respectively in the Prevention of Postpartum Hemorrhage in the Anterior Placenta

目的:研究对比Bakri子宫填塞球囊导管和胎盘剥离面子宫局部缝合分别联合药物治疗在预防前置胎盘产后出血中的优劣差异。方法:选取2016年6月-2018年6月间本院妇产科收治行剖宫产手术的前置胎盘产妇80例作为研究对象进行回顾性研究,根据治疗方法分为试验组(42例)和对照组(38例),两组均采用缩宫素+卡前列素氨丁三醇等药物,对照组产妇在基础治疗上应用胎盘剥离面子宫局部缝合联合药物治疗,试验组产妇在基础治疗上应用Bakri子宫填塞球囊导管联合药物治疗。比较两组患者的治疗效果,手术时间、产后总出血量、术后恶露持续时间和外周白细胞数以及不良反应发生情况。结果:试验组产妇治疗后总有效率明显高于对照组,试验组产妇手术时间及住院时间明显短于对照组,产后总出血量明显少于对照组(P<0.05);两组产妇术后恶露持续时间、白细胞数及C反应蛋白水平比较,差异均无统计学意义(P>0.05);试验组产妇不良反应发生率明显少于对照组(P<0.05)。结论:Bakri子宫填塞球囊导管联合缩宫素和卡前列素氨丁三醇治疗在预防前置胎盘产后出血中的临床效果明显优于胎盘剥离面子宫局部缝合,能够减少出血量,缩短手术时间和住院时间,降低不良反应发生率,值得临床推广及应用。

Objective:To study and compare the differences between the combined drug therapy of Bakri uterine stuffing balloon catheter and placental stripping surface in the prevention of postpartum hemorrhage of anterior placenta.Method:From June 2016 to June 2018,80 cases with anterior placenta of cesarean section in our hospital were selected as the research objects.They were divided into experimental group(42 cases)and control group(38 cases),according to the treatment method.The two groups were treated with Oxytocin + Carboprost Tromethamine and other drugs.The control group was treated with local suture of uterus on the surface of placenta dissection combined with drug therapy.The treatment effect,operation time,total postpartum hemorrhage, postoperative dew duration,peripheral white blood cells and the adverse reactions of two groups were compared. Result:The total effective rate of maternal treatment in the experimental group was significantly higher than that in the control group;the length of stay and the operation time of the experimental group was significantly shorter than those of the control group;the total amount of postpartum hemorrhage was significantly lower than that in the control group(P<0.05).Compared THE duration of postoperative dew,the number of white blood cells and C-reactive protein level of two groups,the differences were not statistically significant(P>0.05).The incidence of maternal adverse reactions in the experimental group was significantly lower than that in the control group(P<0.05). Conclusion:The clinical effect of Bakri uterine stuffing balloon catheter combined with oxytocin and misoprostol in the prevention of anterior placental postpartum hemorrhage is significantly better than that of placental stripping surface uterine local suture combined,which can reduce the amount of bleeding,shorten the operation time and length of stay ,reduce the incidence of adverse reactions,it is worthy of clinical popularization and application.