卡前列素氨丁三醇联合宫腔填纱在前置胎盘剖宫产产后出血治疗中的应用

Application of Carboprosttromethamine Combined with Intrauterine Packing in Postpartum Pemorrhage of Placenta Previa Cesarean Section

目的:探讨卡前列素氨丁三醇联合宫腔填纱在前置胎盘剖宫产产后出血治疗中的应用价值。方法:将2010年12月至2016年12月我科收治的82例行剖宫产的前置胎盘患者随机分为观察组和对照组各41例,观察组采用卡前列醇氨丁三醇联合宫腔填纱联合疗法,对照组采用缩宫素联合米索前列醇舌下含服及宫腔填纱治疗,比较两组患者的术中出血量,术后2 h出血量,术后24 h出血量,并发症的发生率及不良反应发生情况。结果:观察组患者在术中、术后2 h、术后24 h的出血量均明显低于对照组(P<0.05)且无子宫切除病例(对照组2例);术后恶心、呕吐的发生率较对照组高(P<0.05),但两组胸闷发生率及产褥感染发生率无明显差异(P>0.05)。结论:应用卡前列素氨丁三醇宫体注射联合宫腔填纱能有效减少前置胎盘行剖宫产的患者术后出血,但要注意术后恶心、呕吐的发生,并及时做相应处理。

Objective:To evaluate the application of carboprosttromethamine combined with uterine cavity filling in postpartum hemorrhage of placenta previa cesarean section. Methods:82 patients with placenta previa from Dec 2010 to Dec 2016 were randomly divided into observation group and control group,and each group was 42 cases. The observation group was treated with carboprosttromethamine and intrauterine packing. The control group was treated with oxytocin combined with misoprostol sublingual and uterine cavity filling. The bleeding volume,the amount of bleeding at 2 h,at 24 h,the incidence of complications and adverse reactions were compared between the two groups. Results:The bleeding volume and hysterectomy rate in the observation group were significantly lower than those in the control group at intraoperative and 2h,24 h after operation(P<0.05). The incidence of postoperative nausea and vomiting in observation group was significantly higher than those in the control group(P<0.05),but the incidence of chest tightness and puerperal infection was not statistically significant between two the groups(P>0.05). Conclusions:Carboprosttromethamine combined with intrauterine packing can effectively reduce postpartum hemorrhage of placenta previa cesarean section,but it must pay attention to postoperative nausea,vomiting and timely to do the appropriate treatment.