卡前列素氨丁三醇联合宫颈提拉式缝合术在前置胎盘出血中的效果  

Effect of Carboprost Tromethamine Combined With Cervical Pull-Up Suture on Placenta Previa Bleeding

作　　者：李敏仪 李卓 蔡小桃 LI Minyi;LI Zhuo;CAI Xiaotao(Department of Obstetrics,Dalang Hospital of Dongguan,Dongguan Guangdong 523770,China)

机构地区：[1]东莞市大朗医院产科,广东东莞523770

出　　处：《中国卫生标准管理》2024年第22期107-110,共4页China Health Standard Management

基　　金：2022年东莞市社会发展科技项目(20221800900862)。

摘　　要：目的探讨针对前置胎盘剖宫产过程中发生难治性产后出血的产妇应用卡前列素氨丁三醇联合宫颈提拉式缝合术的作用。方法选取2022年1月—2023年12月东莞市大朗医院收治的60例确诊为前置胎盘且行剖宫产术分娩中难治性产后出血的产妇为研究对象。依据随机数字表法分为观察组与对照组,各30例。观察组实施缩宫素、卡前列素氨丁三醇联合宫颈提拉式缝合术,对照组实施缩宫素联合子宫动脉下行支结扎治疗。对比2组术中、术后不同时间点出血量,临床治疗效果及纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D)等凝血功能指标变化和并发症发生情况。结果观察组术后2、12、24 h出血量分别为(674.33±35.37)mL、(908.22±42.24)mL、(1003.24±43.47)mL,均低于对照组的(753.63±40.62)mL、(1110.87±51.15)mL、(1124.54±60.28)mL,差异有统计学意义(P<0.05)。术后24 h,观察组D-D与FIB指标低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。2组均未有子宫切除病例。观察组并发症总发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。结论为前置胎盘剖宫产术中难治性产后出血产妇提供卡前列素氨丁三醇联合宫颈提拉式缝合术进行治疗可减少产妇产后出血量,提高止血疗效,降低并发症发生率,改善凝血功能指标,促进产妇产后更快恢复。Objective To investigate the effect of carprost trochantriol combined with cervical pull-up suture in women with refractory postpartum hemorrhage during placenta previa cesarean section.Methods A total of 60 women diagnosed with placenta previa and refractory postpartum hemorrhage during cesarean section admitted to Dalang Hospital of Dongguan from January 2022 to December 2023 were selected as the study objects.According to the random number table method,they were divided into observation group and control group,30 cases in each group.The observation group was treated with oxytocin,carboprost tromethamine combined with cervical pull-up suture,and the control group was treated with oxytocin combined with ligation of the descending branch of uterine artery.The intraoperative and postoperative bleeding volume,clinical therapeutic effect,changes in coagulation function indexes such as fibrinogen(FIB)and D-dimer(D-D)and the occurrence of complications were compared between the two groups.Results The bleeding volume at 2,12 and 24 h after operation in the observation group were(674.33±35.37)mL,(908.22±42.24)mL and(1003.24±43.47)mL,respectively,which were lower than(753.63±40.62)mL,(1110.87±51.15)mL and(1124.54±60.28)mL in the control group,the differences were statistically significant(P<0.05).At 24 h after operation,D-D and FIB indexes in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 93.33%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05).There were no cases of hysterectomy in both groups.The total incidence rate of complications in the observation group was 6.67%,which was lower than 26.67%in the control group,the difference was statistically significant(P<0.05).Conclusion Providing carboprost tromethamine combined with cervical pull-up suture for the treatment of refractory postpartum hemorrhage in cesarean section with placen

关 键 词：卡前列素氨丁三醇 宫颈提拉式缝合术 前置胎盘 难治性产后出血 剖宫产 凝血功能 

分 类 号：R714[医药卫生—妇产科学]