卡前列素氨丁三醇注射液联合B-Lynch缝合术治疗宫缩乏力性产后出血的临床效果及对子宫复旧的影响

Clinical effect of carboprost tromethamine injection combined with B-Lynch suture in the treatment of postpartum hemorrhage caused by uterine inertia and its influence on uterine involution

目的分析卡前列素氨丁三醇注射液联合B-Lynch缝合术治疗宫缩乏力性产后出血的临床效果。方法将150例宫缩乏力性产后出血患者按照治疗方式分为对照组与观察组,各75例。对照组给予缩宫素联合B-Lynch缝合术治疗,观察组给予卡前列素氨丁三醇注射液联合B-Lynch缝合术。比较两组的临床效果。结果观察组的止血时间、术中出血量、术后24 h阴道出血量、术后24 h的Hb水平、住院时间均优于对照组(P<0.05)。治疗后,两组的APTT、PT均缩短,FIB水平均升高,且观察组优于对照组(P<0.05)。术后14、30 d,观察组的子宫体积小于对照组(P<0.05);术后1、3、7 d,观察组的宫底下降高度大于对照组(P<0.05)。观察组的月经周期及月经量均优于对照组(P<0.05)。结论卡前列素氨丁三醇注射液联合B-Lynch缝合术治疗宫缩乏力性产后出血的止血效果较好,可改善患者的凝血功能,促进子宫复旧,减少对月经及生育能力的影响。

Objective To analyze the clinical effect of carboprost tromethamine injection combined with B-Lynch suture in the treatment of postpartum hemorrhage caused by uterine inertia.Methods A total of 150 patients with postpartum hemorrhage caused by uterine inertia were divided into control group and observation group according to the treatment mode,with 75 cases in each group.The control group was given oxytocin combined with B-Lynch suture,and the observation group was given carboprost tromethamine injection combined with B-Lynch suture.The clinical effects of the two groups were compared.Results The hemostasis time,intraoperative bleeding volume,postoperative 24 h vaginal bleeding volume,postoperative 24 h Hb level and hospitalization time in the observation group were better than those in the control group(P<0.05).After treatment,the APTT and PT in the two groups shorten,and FIB level increased,and those in the observation group were better than the control group(P<0.05).At 14,30 d after operation,the uterine volumes in the observation group were smaller than those in the control group(P<0.05);at 1,3,7 d after operation,the heights of uterine fundus decrease in the observation group were greater than those in the control group(P<0.05).The menstrual cycle and menstrual volume in the observation group were better than those in the control group(P<0.05).Conclusion The carboprost tromethamine injection combined with B-Lynch suture in the treatment of postpartum hemorrhage caused by uterine inertia has a good hemostatic effect,it can improve the coagulation function,promote the uterine involution,and reduce the impact on menstruation and fertility.