宫腔填纱联合宫缩剂治疗前置胎盘剖宫产术中出血临床效果

Clinical Effect of Uterine Cavity Filling Combined with Uterine Contraction Agent on Bleeding during Cesarean Section of Placenta Previa

目的:观察分析宫腔纱条填塞联合宫缩剂(卡前列素氨丁三醇注射液、卡贝缩宫素)治疗前置胎盘剖宫产术中出血的临床效果。方法:此次治疗研究将54例2012年1月-2018年7月笔者所在医院收治的前置胎盘并行剖宫产术中出血的患者作为研究对象,已排除凶险性前置胎盘并行子宫切除患者4例,所有患者均无凝血系统障碍及宫缩剂药物禁忌,按照分组试验的方法展开此次研究,其中18例为单纯应用宫缩剂(卡前列素氨丁三醇注射液、卡贝缩宫素)治疗,未行宫腔填纱患者,作为参照研究组,另外36例患者为宫腔填纱及宫缩剂联合治疗组,比较探究两组患者的止血及治疗情况。结果:联合治疗组患者平均产后止血耗时及产后出血量均少于参照研究组患者,差异均有统计学意义(P<0.05)。两组术后均应用抗生素治疗,联合治疗组出院时间(3.33±0.31)d,参照研究组为(3.29±0.30)d,差异无统计学意义(P>0.05)。结论:前置胎盘剖宫产术中,在应用有效宫缩剂同时,快速果断宫腔填纱,可有效减少出血及术中止血耗时。

Objective:To observe and analyze the clinical effect of uterine gauze packing combined with uterine contractile agents(Carprostol Tromethamine Injection,Kabe)in the treatment of bleeding during cesarean section of placenta previa.Method:54 patients with placenta previa and bleeding during cesarean section admitted to our hospital from January 2012 to July 2018 were selected as the research objects.Four patients with dangerous placenta previa and hysterectomy were excluded.All patients had no coagulation system disorder and contraindication of uterine contraction agents.The study was conducted according to the method of grouping experiment.Among them,18 patients used only uterine contraction agents(Carboprost Tromethamine Injection,Kabe)treatment,no uterine filling patients,as a reference group,another 36 patients for uterine filling and uterine contraction agent combined treatment group,to compare and explore the two groups of patients with hemostasis and treatment.Result:The average postpartum hemostasis time and the amount of postpartum hemorrhage in the combined treatment group were less than those in the control group(P<0.05).Both groups were treated with antibiotics after operation.The discharging time of the combined treatment group was(3.33±0.31)days,while that of the control group was(3.29±0.30)days.There was no significant difference between the two groups(P>0.05).Conclusion:The application of effective uterine contraction agent and rapid and decisive intrauterine gauze filling during cesarean section of placenta previa can effectively reduce bleeding and hemostasis time.