子宫B-Lynch和宫颈提拉缝合术联合卡前列素氨丁三醇在前置胎盘产后出血中的应用效果

Application of uterine B-Lynch suture and cervical lifting suture combined with carboprost tromethamine in postpartum hemorrhage of placenta previa

目的:探究子宫B-Lynch+宫颈提拉缝合术联合卡前列素氨丁三醇在前置胎盘产后出血中的应用效果。方法:118例前置胎盘患者按照治疗方式不同分为观察组(n=60)和对照组(n=58)。观察组采用子宫B-Lynch+宫颈提拉缝合术联合卡前列素氨丁三醇治疗;对照组采用子宫按摩+宫颈提拉缝合术联合卡前列素氨丁三醇治疗。比较两组患者临床疗效、术后出血量、术中及术后情况、术后舒适度[舒适状况量表(GCQ)评分、疼痛数字评分法(NRS)评分]、产后12个月激素水平[卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E_(2))]。结果:观察组患者总有效率高于对照组(P<0.05)。术后2、12、24 h,观察组患者出血量低于对照组(P<0.05)。两组患者术中出血量、输血量、手术时间、产后感染、恶露持续时间、月经复潮时间、第一次月经量、产后月经周期、宫底高度比较,差异无统计学意义(P>0.05);观察组患者子宫复旧高于对照组,恶露量和子宫体积低于对照组(P<0.05)。术后,观察组患者GCQ评分高于对照组(P<0.05),NRS评分低于对照组(P<0.05)。产后12个月,两组患者FSH、LH、E_(2)水平比较,差异无统计学意义(P>0.05)。结论:子宫B-Lynch+宫颈提拉缝合术联合卡前列素氨丁三醇能够有效控制前置胎盘产后出血,减少出血量,促进子宫复旧。

Objective:To explore the application effect of uterine B-Lynch suture+cervical lifting suture combined with carboprost tromethamine in the treatment of postpartum hemorrhage of placenta previa.Methods:118 patients with placenta previa were divided into observation group(n=60)and control group(n=58)according to different treatment methods.The observation group was treated with uterine B-Lynch suture+cervical lifting suture combined with carboprost tromethamine,and the control group was treated with uterine massage+cervical lifting suture combined with carboprost tromethamine.The clinical efficacy,postoperative hemorrhage volume,surgery status and postoperative status,postoperative comfort[General Comfort Questionnaire(GCQ),Numeric Rating Scale(NRS)]and levels of hormones at 12 months after delivery[Follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2))]were compared between the two groups of patients.Results:The total effective rate of observation group was significantly higher than that of control group(P<0.05).At 2,12 and 24 h after surgery,the hemorrhage volume of observation group was significantly less than that of control group(P<0.05).There were no statistical differences in the intraoperative blood loss,blood transfusion volume,surgical time,postpartum infection,lochia duration,menstrual recovery time,first menstrual volume,postpartum menstrual cycle and height of fundus between the two groups(P>0.05).Uterine involution in observation group was significantly better than that in control group,and the amount of lochia and uterine volume were significantly less than those in control group(P<0.05).The GCQ score in observation group was significantly higher than that in control group while the NRS score was significantly lower than that in control group(P<0.05).At 12 months after delivery,there was no significant difference in the levels of FSH,LH and E_(2) between the two groups(P>0.05).Conclusion:Uterine B-Lynch suture+cervical lifting suture combined with carboprost tromethamine can effectively control the postpartum hemorrhage of placenta previa,reduce the hemorrhage volume,and promote the uterine involution.