欣母沛联合低位B-Lynch缝合术治疗难治性前置胎盘产后出血的效果观察

Effect of hemabate combined with low B-Lynch suture in the treatment of refractory placenta previa postpartum hemorrhage

目的探讨欣母沛联合低位B-Lynch缝合术治疗难治性前置胎盘产后出血的效果。方法回顾性分析2017年2月至2019年8月山西省妇幼保健院收治的96例难治性前置胎盘产后出血患者的临床资料,根据治疗方法将患者分为对照组(48例)和观察组(48例)。对照组采用缩宫素联合"8"字间断缝合术治疗,观察组采用欣母沛联合低位B-Lynch缝合术治疗。比较两组疗效、出血量以及术后子宫体积变化状况。结果观察组治疗总有效率为97.92%(47/48),高于对照组的83.33%(40/48),差异有统计学意义(P<0.05)。观察组术后2 h阴道出血量为(60.39±12.64)ml,术后24 h阴道出血量为(31.26±6.41)ml,均低于对照组的(124.43±24.72)、(65.68±9.27)ml,差异有统计学意义(P<0.05)。观察组术后30、45 d子宫体积为(167.53±18.29)、(103.14±15.29)cm3,均小于对照组的(208.42±23.46)、(146.19±18.37)cm3,差异有统计学意义(P<0.05)。结论难治性前置胎盘产后出血患者采用欣母沛联合低位B-Lynch缝合术治疗效果确切,可减少术后出血量,促进子宫恢复。

Objective To investigate the efficacy of hemabate combined with low B-Lynch suture in the treatment of refractory placenta previa postpartum hemorrhage.Methods The clinical data from 96 patients with refractory placenta previa postpartum hemorrhage treated in Shanxi Maternal and Child Health Care Hospital from February 2017 to August 2019 were analyzed.And enrolled patients were divided into control group(48 cases)and observation group(48 cases)by their treatment methods.Patients in the control group were treated by oxytocin and interrupted figure 8 suture,and patients in the observation group were treated by hemabate and low B-Lynch suture.The curative effects,volume of bleeding and uterine volume were compared between the two groups.Results The total effective rate of treatment in the observation group was 97.92%(47/48),higher than the 83.33%(40/48)in the control group(P<0.05).The vaginal blood loss at 2 and 24 h after operation in the observation group were(60.39±12.64)ml and(31.26±6.41)ml,respectively,which were lower than the(124.43±24.72)ml and(65.68±9.27)ml in the control group(P<0.05).The uterine volumes in the observation group at 30 and 45 d after treatment were(167.53±18.29)cm3 and(103.14±15.29)cm3,respectively,which were smaller than the(208.42±23.46)cm3 and(146.19±18.37)cm3 in the control group(P<0.05).Conclusions Hemabate combined with low B-Lynch suture is effective in the treatment of refractory placenta previa postpartum hemorrhage,which can reduce postoperative bleeding and promote uterine recovery.