宫颈提拉缝合术治疗前置胎盘剖宫产术中出血的临床效果观察  

The clinical effect of cervical lift suture in the treatment of intraoperative bleeding during placenta previa cesarean section

作　　者：周严娟 李丽 凌利[2] 张玮 Zhou Yanjuan;Li Li;Ling Li;Zhang Wei(Department of Obstetrics,the Second People's Hospital of Wuhu City,Wuhu 241000,China;Department of Obstetrics,Yijishan Hospital,Wannan Medical College,Wuhu 241000,China)

机构地区：[1]芜湖市第二人民医院产科,芜湖241000 [2]皖南医学院弋矶山医院产科,芜湖241000

出　　处：《中国医师进修杂志》2024年第8期713-717,共5页Chinese Journal of Postgraduates of Medicine

基　　金：芜湖市科技计划项目(2021CG44)。

摘　　要：目的探讨卡前列素氨丁三醇、缩宫素联合宫颈提拉缝合术用于前置胎盘剖宫产术中出血的效果。方法回顾性分析2020年7月至2022年7月芜湖市第二人民医院诊治的38例前置胎盘剖宫产术中出血产妇的临床资料,按照治疗方式不同分为观察组(18例,剖宫产术中采用卡前列素氨丁三醇、缩宫素联合宫颈提拉缝合术)和对照组(20例,剖宫产术中采用卡前列素氨丁三醇联合缩宫素),比较两组临床疗效、术前和术后2 h血流动力学参数、出血量、血常规指标和术后恢复情况。结果两组总有效率比较差异无统计学意义(P>0.05)。两组术后2 h收缩压、舒张压、脉搏及血氧饱和度(SpO2)与术前比较差异无统计学意义(P>0.05),两组术后2 h上述指标组间比较差异无统计学意义(P>0.05)。观察组术中和术后2、24 h出血量低于对照组[(612.50±183.44)ml比(727.50±168.91)ml、(83.82±20.64)ml比(103.48±26.93)ml、(117.70±24.02)ml比(136.25±30.51)ml],差异有统计学意义(P<0.05)。两组术前及术后24 h红细胞压积比较差异无统计学意义(P>0.05);观察组术后24 h血红蛋白下降值低于对照组[(15.74±2.66)g/L比(18.05±3.58)g/L],差异有统计学意义(P<0.05)。两组均无产后感染病例;观察组和对照组子宫复旧不良、恶露持续时间比较差异无统计学意义(P>0.05)。结论卡前列素氨丁三醇、缩宫素联合宫颈提拉缝合术能够有效控制前置胎盘术中出血,减少出血量和术后24 h血红蛋白下降值。Objective:To explore the effect of carboprost tromethamine and oxytocin combined with cervical lift suture for intraoperative bleeding of placenta previa cesarean section.Methods:A retrospective analysis was performed on 38 cases of intraoperative bleeding of placenta previa cesarean section in the Second People′s Hospital of Wuhu City from July 2020 to July 2022.According to different treatment methods,they were divided into the observation group(18 cases,treated by carboprost tromethamine and oxytocin combined with cervical lift suture)and the control group(20 cases,treated by carboprost tromethamine combined with oxytocin).The clinical efficacy,hemodynamic parameters before and 2 h after operation,blood loss,blood routine indicators,postoperative recovery of the two groups were compared.Results:The total effective rate between the two groups had no statistical difference(P>0.05).At 2 h after operation,the systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse and blood oxygen saturation(SpO 2)in the two groups had no statistical differences compared with those before operation(P>0.05),and had no statistical differences between the two groups(P>0.05).The blood loss at 2 h and 24 h after operation in the observation group were lower than those in the control group:(612.50±183.44)ml vs.(727.50±168.91)ml,(83.82±20.64)ml vs.(103.48±26.93)ml,(117.70±24.02)ml vs.(136.25±30.51)ml,there were statistical differences(P<0.05).There were no statistical differences in hematocrit between the two groups before and 24 h after surgery(P>0.05).The decrease of hemoglobin in the observation group at 24 h after surgery was lower than that in the control group:(15.74±2.66)g/L vs.(18.05±3.58)g/L,there was statistical difference(P<0.05).There were no statistical differences in postpartum infection,poor uterine involution and duration of lochia between the two groups(P>0.05).Conclusions:Carboprost tromethamine and oxytocin combined with cervical lift suture can effectively control intraoperative bleeding of placenta

关 键 词：前置胎盘 剖宫产术 出血 卡前列素氨丁三醇 缩宫素 宫颈提拉缝合术 

分 类 号：R719.8[医药卫生—妇产科学]