宫颈钳夹术联合缩宫素治疗宫缩乏力性产后出血的临床效果

Clinical effect of cervical clamp combined with oxytocin in the treatment of postpartum hemorrhage caused by uterine inertia

目的观察宫颈钳夹术联合缩宫素治疗宫缩乏力性产后出血的临床效果。方法分析2017年9月至2019年1月在我院分娩后发生宫缩乏力性产后出血的72例患者的临床资料,根据治疗方式的不同将其分为对照组和观察组,每组36例。对照组采用缩宫素治疗,观察组采用宫颈钳夹术联合缩宫素治疗。比较两组临床治疗效果、出血量、治疗起效时间、住院时间、血红蛋白(HGB)、红细胞比容(HCT)、纤维蛋白原(FIB)、D-二聚体(D-D)水平及并发症发生情况。结果观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);观察组治疗后2h及2~24h出血量均显著少于对照组,治疗起效时间及住院时间均显著短于对照组,差异有统计学意义(P<0.05);治疗后24h,两组HGB、HCT、FIB、D-D水平均较治疗前显著下降,但观察组显著高于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论宫颈钳夹术联合宫缩素能够显著提高宫缩乏力性产后出血的治疗有效率,减少患者出血量,降低并发症发生率,值得临床推广应用。

Objective To observe the clinical effect of cervical clamp combined with oxytocin in the treatment of postpartum hemorrhage caused by uterine inertia. Methods The clinical data of 72 patients with postpartum hemorrhage caused by uterine inertia after delivery in our hospital from September 2017 to January 2019 were analyzed. The patients were divided into control group and observation group according to different treatment methods, with 36 cases in each group. The control group was treated with oxytocin, while the observation group was treated with cervical clamp combined with oxytocin. The clinical efficacy, amount of bleeding, time to onset, hospital stay, levels of hemoglobin (HGB), hematocrit (HCT), fibrinogen (FIB) and D-dimer (D-D) and complications were compared between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The amount of bleeding at 2 and 2-24 h after treatment in the observation group were significantly lower than those in the control group, and the time to onset and hospital stay were significantly shorter than those in the control group, with statistically significant differences (P<0.05). At 24 hours after treatment, the levels of HGB, HCT, FIB and D-D in the two groups were significantly lower than those before treatment, but those in the observation group were significantly higher than the control group, the differences were statistically significant (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Cervical clamp combined with oxytocin can significantly improve the treatment efficiency of postpartum hemorrhage caused by uterine inertia, reduce the amount of bleeding and incidence of complications, which is worthy of clinical application.