顽固性宫缩乏力产后出血的治疗  

A summary of experience in the treatment of intractable postpartum hemorrhage caused by uterine inertia

作　　者：黄志巧[1] 

机构地区：[1]广东省深圳市妇幼保健院产一区,深圳518028

出　　处：《临床医学》2016年第2期22-23,共2页Clinical Medicine

摘　　要：目的探讨改良B-Lynch缝合联合欣母沛治疗顽固性宫缩乏力产后出血的效果。方法选取深圳市妇幼保健院产科收治的顽固性宫缩乏力产后出血患者58例作为研究对象,采用数字随机将患者随机均分为两组,对照组予以改良B-Lynch缝合联合缩宫素治疗,观察组予以改良B-Lynch缝合联合欣母沛治疗,记录两组术中出血量、术后24 h出血量、止血时间,记录两组输血率、产褥病发生率、子宫切除率、病死率及两组患者用药不良反应。结果观察组术中出血量、止血时间、术中输血量分别为(876.39±241.26)ml、(9.26±1.05)min、(451.26±158.36)ml,与对照组比较差异有统计学意义(P<0.05);观察组输血率和产褥病发生率分别为17.24%、6.90%,与对照组比较差异有统计学意义(P<0.05)。结论改良B-Lynch缝合联合欣母沛能够有效控制难治性宫缩乏力产后出血,降低子宫切除率。Objective To investigate the effect of modified B-Lynch suture combined with hemabate on intractable postpartum hemorrhage caused by uterine inertia. Methods Fifty-eight patients with intractable postpartum hemorrhage caused by uterine inertia were selected as the research objects and were randomly divided into two groups. The control group was treated by modi-fied B-Lynch suture combined with oxytocin while the observation group was treated by modified B-Lynch suture combined with hemabate. The intraoperative volume of blood loss,the amount of bleeding 24 h after the operation,the time of hemostasis,the rate of blood transfusion,the incidence rate of puerperalism,the rate of uterus resection,the mortality and drug adverse reactions of the two groups were recorded. Results The intraoperative amount of bleeding,time of hemostasis,the intraoperative amount of blood transfusion respectively were（876. 39 ± 241. 26）ml,（9. 26 ± 1. 05）min,（451. 26 ± 158. 36）ml,which were signifi-cantly different from the control group（P ﹤ 0. 05）;The rate of blood transfusion and the incidence rate of puerperalism of the ob-servation group were 17. 24% and 6. 90% respectively,which were significantly different from the control group（P ﹤ 0. 05）. Conclusion The modified B-Lynch suture combined with hemabate can effectively control the intractable postpartum hemorrhage caused by uterine inertia and reduce the rate of hysterectomy.

关 键 词：顽固性产后出血 宫缩乏力 改良B-Lynch缝合 欣母沛 出血量 

分 类 号：R714.461[医药卫生—妇产科学]