宫腔球囊填塞与宫腔塞纱在孕14~28周瘢痕子宫伴胎盘植入孕妇引产过程中的应用效果比较  

Comparison of Uterine Balloon Tamponade and Uterine Plug Yarn in the Labor Induction Process of Pregnant Women with Scar Uterus and Placenta Implantation at 14~28 Weeks of Pregnancy

作　　者：张秀娜 ZHANG Xiuna(Department of Obstetrics and Gynecology,Zhecheng County People's Hospital,Shangqiu Henan 476200,China)

机构地区：[1]柘城县人民医院妇产科,河南商丘476200

出　　处：《临床研究》2022年第10期79-82,共4页Clinical Research

摘　　要：目的比较宫腔球囊填塞与宫腔塞纱在孕14~28周瘢痕子宫伴胎盘植入孕妇引产过程中的应用效果。方法选取柘城县人民医院2018年5月至2020年6月期间接收的86例孕14~28周瘢痕子宫伴胎盘植入引产患者作为研究对象,结合随机数字表法分为球囊组与塞纱组,各43例,均采用米非司酮、米索前列醇联合应用引产,且待娩出胎盘后,予以宫缩剂和子宫按摩等,在此基础上,塞纱组接受宫腔塞纱,球囊组接受宫腔球囊填塞。统计对比引产2 h、引产12 h、引产24 h出血量,两组止血效果,预后状况(住院时间、子宫动脉栓塞状况以及输血状况),不良事件发生状况,子宫恢复状况(恶露排净时间、月经复潮时间),术后1个月、术后2个月、术后3个月血清性激素水平[雌二醇(E_(2))、卵泡刺激素(FSH)、黄体生成素(LH)],术后2 h凝血指标[D-二聚体(D-D)、凝血酶时间(TT)、凝血酶原时间(PT)]。结果球囊组引产2 h、引产12 h、引产24 h出血量少于塞纱组,差异有统计学意义(P<0.05);球囊组止血有效率(97.67%)高于塞纱组(81.40%),差异有统计学意义(P<0.05);球囊组住院时间短于塞纱组,球囊组子宫动脉栓塞率、输血率少于塞纱组,差异有统计学意义(P<0.05);球囊组不良事件发生率低于塞纱组,差异有统计学意义(P<0.05);两组恶露排净时间、月经复潮时间比较,差异无统计学意义(P>0.05);术后1个月、术后2个月、术后3个月两组血清E_(2)、FSH、LH水平对比,差异无统计学意义(P>0.05);术后2 h球囊组D-D低于塞纱组,TT、PT短于塞纱组,差异有统计学意义(P<0.05)。结论与宫腔塞纱相比较,孕14~28周瘢痕子宫伴胎盘植入孕妇引产过程中应用宫腔球囊填塞,可减少出血量,增强止血效果,减少住院时间,降低子宫动脉栓塞率、输血率,降低不良事件发生风险,安全性有保障,保护卵巢功能,改善凝血功能。Objective To compare the application effect of uterine balloon tamponade and uterine plug yarn in the labor induction process of pregnant women with scar uterus and placenta implantation from 14 to 28 weeks of pregnancy.Methods A total of 86 patients with scar uterus and placenta implantation from 14 to 28 weeks of pregnancy admitted in our hospital from May 2018 to June 2020 were selected as subjects and divided into uterine balloon group and plug yarn group by the random number table method,with 43 cases in each group.In two groups,mifepristone and misoprostol were used to induce labor,and after delivering the placenta,giving the contractions and uterine massage,on this basis,the plug yarn group received the uterine plug yarn and the uterine balloon group received the uterine balloon tamponade.The amount of bleeding after 2 h,12 h,24 h,hemostasis effect,prognosis(hospital time,uterine artery embolism and transfusion status),adverse events,uterine recovery(lochia discharge net time,menstrual return tide time),1 month,2 months,3 months postoperative serum sex hormone levels[estradiol(E_(2)),follicle stimulating hormone(FSH),luteinizing hormone(LH)],2 h postoperative coagulation index[D-dimer(D-D),thrombin time(TT),prothrombin time(PT)]were compared between two groups.Results The bleeding volume after 2 h,12 h and 24 h in uterine balloon group were less than those in the plug yarn group(P<0.05);The hemostasis effective rate of the uterine balloon group(97.67%)was higher than that of the plug yarn group(81.40%),and the difference was statistical significant(P<0.05);The length of hospitalization in the uterine balloon group was shorter than that in the plug group,and the uterine artery embolism rate and blood transfusion rate in the uterine balloon group were less than those in the plug yarn group,and the differences were statistically significant(P<0.05);The incidence of adverse events in the uterine balloon group was lower than that in the plug yarn group(P<0.05);There were no significant differences in the lochia

关 键 词：宫腔塞纱 宫腔球囊填塞 孕14~28周 瘢痕子宫 胎盘植入 引产 

分 类 号：R714[医药卫生—妇产科学]