卡前列素氨丁三醇 缩宫素联合宫腔球囊填塞术治疗前置胎盘剖宫产后出血对照研究

Application of carboprost tromethamine and oxytocin combined with intrauterine balloon tamponade in patients with postpartum placenta cesarean section for postpartum hemorrhage

目的探讨卡前列素氨丁三醇、缩言素联合宫腔球囊填塞术治疗前置胎盘剖宫产产后出血患者的临床效果.方法将58例前置胎盘剖宫产产后出血患者根据治疗方案分为实验组与对照组,每组29例,对照组给予胎盘剥离面子宫局部缝合+卡前列素氨丁三醇+缩宫素注射液治疗,实验组在对照组基础上给予宫腔球填塞术治疗.比较两组临床疗效、住院时间、术中及术后2h-24 h出血量、恶露持续时间、不良反应,治疗3个月、6个月、9个月检测两组血清性激素(雌二醇、卵泡雌激素)水平.结果实验组总有数率(93.1%)显著高于对照组(69.0%)(P<0.05),住院时间显著短于对照组(P<0.01),术中及术后2h-24 h出血量显著少于对照组(P<0.01),恶露持续时间、不良反应发生率及治疗3个月、6个月、9个月血清雌二醇、卵泡雌激素水平与对照组比较差异均无统计学意义(P>0.05).结论采用卡前列素氨丁三醇、缩宫素联合宫腔球囊填塞术治疗前置胎盘剖宫产产后出血患者效果显著,可减少术中、术后出血量,缩短住院时间,且安全性高.

Objective To observe the application value of carboprost tromethamine and oxytocin injection combined with intrauterine balloon tamponade in patients with postpartum placenta cesarean section for postpartum hemorrhage.Methods 58 cases of postpart um hemorrhage after cesarean section with placenta previa were selected and divided into experimental group and the control group according to the treatment plan,29 cases each.The control group was treated with local suture of uterus on the dissected surface of placenta+carboprost tromethamine+oxytocin injection.On the basis of the control group,the experimental group was given intrauterine balloon tamponade.The clinical efficacy,hospitalization time,2 to 24 h bleeding volume,duration of lochia and adverse reactions of the two groups were observed.The levels of sex hormones(E2,FSH)were compared at 3,6 and 9 months after treatment.Results The total effective rate of treatment in the experimental group was 93.1%,higher than 69.0%in the control group(P<0.01).The length of hospitalization in the experimental group was shorter than that in the control group(P<0,01),the amount of bleeding during operation and 2-24 hours after operation was less.than that in the control group(P<0.01).There was no significant difference in the duration of the lochia,the ineidence of adverse reactions,and the levels of serum estradiol and follicular estrogen at 3 months,6 months,and 9 months after treatment(P>0.05).Conclusions Patients with postpartum hemorrhage due to placenta previa by cesarean balloon tamponade combined with carboprost tromethamine and oxytocin injection have a significant effect,which can reduce the amount of intraoperative and postoperative bleeding,shorten the length of hospital stay,and has high safety.