欣母沛、子宫背带缝扎术及阴道填纱联合治疗剖宫产宫缩乏力性出血的临床研究

Clinical Study on the Treatment of Hemorrhage Due to Cesarean Section Uterine Contraction with Xinmupei,Uterine Strap Suture and Vaginal Gauze

目的探究在剖宫产宫缩乏力性出血中,施行卡前列素氨丁三醇注射液(欣母沛)、子宫背带缝扎术及阴道填纱综合治疗的临床疗效及可行性。方法选取2018年3月—2020年3月在该院行剖宫产术,术中出现宫缩乏力性出血的56例产妇,随机分为对照组及观察组各28例。对照组予以子宫背带缝扎术配合缩宫素治疗。观察组予以子宫背带缝扎术及阴道填纱配合卡前列素氨丁三醇注射液、缩宫素治疗。比较两组各项临床指标。结果观察组治疗有效率为96.42%,对照组治疗有效率为71.42%,临床止血有效率观察组显著高于对照组,差异有统计学意义(χ^(2)=4.766,P=0.029);观察组手术时间、住院时间、术中出血量和术后24 h出血量明显低于对照组,差异有统计学意义(t=2.574、3.425、17.558、18.480,P<0.05);观察组并发症发生情况为1例(3.57%),对照组并发症发生情况为13例(46.43%),观察组发生率低于对照组,差异有统计学意义(χ^(2)=13.714,P<0.001)。结论卡前列素氨丁三醇注射液、子宫背带缝扎术及阴道填塞纱布治疗剖宫产宫缩乏力性出血,止血效果好,能有效减少出血量、缩短手术时间及住院时间、减少术后并发症的发生、降低子宫切除率。

Objective To explore the clinical efficacy and feasibility of the combined treatment of carprost tromethamine injection(Xinmupei),uterine sling ligation and vaginal gauze filling in cesarean section uterine fatigue bleeding.Methods Selected 56 parturients who underwent cesarean section in the hospital from March 2018 to March 2020 and experienced uterine asthenia bleeding during the operation.They were randomly divided into a control group and an observation group,with 28 cases in each group.The control group was treated with uterine strap suture combined with oxytocin.The observation group was treated with uterine strap ligation and vaginal gauze,carprost tromethamine injection and oxytocin.Compared the clinical indicators of the two groups.Results The therapeutic efficiencerate of observation group was 96.42%,and the therapeutic efficiencerate of control group was 71.42%.The clinical hemostatic effective rate in the observation group was significantly higher than that in the control group,the difference was statistically significant(χ^(2)=4.766,P=0.029);the operation time,hospitalization time,intraoperative blood loss and 24 h postoperative blood loss in the observation group were significantly lower than those in the control group,the difference was statistically significant(t=2.574,3.425,17.558,18.480,P<0.05);the infection complications of observation group was 1 case(3.57%),and the control group had the complications was 13 cases(46.43%).The incidence rate of complications in the observation group was lower than that in the control group,the difference was statistically significant(χ^(2)=13.714,P<0.001).Conclusion Carprostol injection,modified B-Lynch suture and vaginal gauze in the treatment of uterine uterine fatigue hemorrhage after cesarean section has good hemostatic effect,can effectively reduce the amount of bleeding,shorten the operation time and hospital stay,reduce the incidence of postoperative complications,reduce the rate of hysterectomy.