子宫下段防波堤样缝合术联合麦角新碱治疗前置胎盘产后出血疗效及效益分析

Curative and economic analysis of lower uterine breakwater-like suture combined with ergonovine for treating postpartum hemorrhage with placenta previa

目的:探讨子宫下段防波堤样缝合术联合麦角新碱治疗前置胎盘剖宫产产后出血疗效及经济效益。方法:选取2017年1月-2019年6月入本院诊疗的102例前置胎盘剖宫产产后出血患者,根据止血方法不同分为两组各51例,对照组采用子宫下段防波堤样缝合术,观察组采用子宫下段防波堤样缝合术联合麦角新碱,比较两组术中、术后2 h、24 h出血量及总出血量,血红蛋白(Hb)、红细胞(RBC)计数、Ca^(2+)浓度、凝血功能、不良反应,比较临床疗效及经济性。结果:观察组平均药物治疗费用(287.7元)低于对照组(561.20元),术中、术后2 h、术后24h出血量及总出血量、Ca^(2+)浓度以及不良反应发生率均低于对照组,血红蛋白(Hb)、红细胞(RBC)计数高于对照组,药物成本-效果比(2.95)低于对照组(6.41),术中出血量(361.12±154.31 ml)、术后2h出血量(403.51±113.71 ml)、术后24h出血量(467.39±129.68 ml)均少于对照组(P<0.05)。结论:联合治疗可降低前置胎盘剖宫产术中出血量,提高机体凝血功能,治疗后不良反应发生率低,降低了治疗成本。

Objective:To investigate the curative and economic analysis of lower uterine breakwater-like suture combined with ergonovine for treating postpartum hemorrhage of women with placenta previa.Methods:102 women with placenta previa and postpartum hemorrhage were selected and divided into control group and observation group(51 cases in each group)according to different methods of hemostasis from January 2017 to June 2019.The women in the control group were given lower uterine breakwater-like suture only for hemostasis,and the women in the observation group were given lower uterine breakwater-like suture combined with ergonovine for hemostasis.The blood loss during operation and in postoperative 2 h and 24 h,the total blood loss,the hemoglobin(Hb)level,the red blood cell(RBC)count,the Ca^(2+)concentration,the coagulation function,the incidence of adverse reactions,the clinical efficacy,and economic analysis of the women were compared between the two groups.Results:The average drug treatment cost(287.7 Yuan)of the women in the observation group was significant lower than that(561.20 Yuan)of the women in the control group.The amount of blood loss during operation and in postoperative 2 h and 24 h,the total blood loss amount,the concentration of Ca^(2+),and the incidence of adverse reaction of the women in the observation group were significant lower than those of the women in the control group.The H)level and RBC counts of the women in the observation group were significant higher than those of the women in the control group.The drug cost-effectiveness ratio(2.95)of the women in the observation group was significant lower than that(6.41)of the women in the control group.The amount of intraoperative blood loss(361.12±154.31 ml),the amount of blood loss in postoperative 2 h(403.51±113.71 ml),and the amount of blood loss in postoperative 24 h(467.39±129.68 ml)of the women in the observation group were significant lower than those of the women in the control group(P<0.05).Conclusion:Lower uterine breakwater-like suture combined with ergonovine for treating women with placenta previa can reduce the amount of blood loss during cesarean section and improve their coagulation function.The incidence of adverse reactions after treatment and the cost of therapy are low.