无齿卵圆钳用于子宫下段收缩乏力所致产后出血的临床研究(1)
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【摘要】 目的 探讨无齿卵圆钳用于子宫下段收缩乏力所致的产后出血的临床疗效。方法 对2007年1月至2010年5月55例因子宫下段收缩乏力所致产后出血患者随机分为2组:对照组24例和观察组31例。对照组 采用按摩子宫、注射缩宫素、欣母沛等治疗;观察组在对照组治疗的同时立即用无齿卵圆钳钳夹住宫颈及子宫下段。对比2组产后出血的情况。 结果 观察组治疗后2、24 h出血量均明显少于观察组(均 P<005)。结论 在子宫下段收缩乏力所致的产后出血的患者中用无齿卵圆钳钳夹宫颈及子宫下段是治疗产后出血、减少出血量的一种简便、快捷、有效的方法,值得临床推广应用。
【关键词】
无齿卵圆钳;欣母沛;子宫下段收缩乏力;产后出血
Clinical study on using toothless oval clamp on preventing postpartum hemorrhage caused by uterine segment weak contraction
LIU Shengying,HE Hui.Gongming People’s Hospital of Shenzhen,518106,China
【Abstract】 Objective To explore the effect of curing postpartum hemorrhage caused by uterine segment weak contraction by clamping uterine segment with toothless oval clamp Methods 54 cases of postpartum hemorrhage caused by uterine segment weak contraction from January 2007 to May 2010 were randomly divided into two groups: contrast group(24 cases) and observation group(31 cases) The patients in two groups injected hemabate and oxytocin into their uterine corpus after delivery respectively, with uterine massage, observation group, added in clamping uterine segment with toothless oval clamp immediately Compared rates of postpartum hemorrhage in two groups Results The bleeding amounts at 2 hours and 24 hours after delivery in observation group were both less than those in contrast group(P<005).Conclusion The treatment of curing postpartum hemorrhage caused by uterine segment weak contraction with the method of clamping uterine segment with toothless oval clamp is effective ,simple, and quick.It is worth to promote.
【Key words】
Toothless oval clamp;Henabate Uterine segment weak contraction;Postpartum hemorrhage
产后出血是产科最严重的并发症之一,发生较高 ,占分娩总数 的 2%～ 3%[1];出血发生突然,80%上发生在产后2 h内[2],在我国居产妇死亡原因的首位。产后出血原因多数为宫缩乏力所致,其中有一部分为子宫下段收缩不良,表现为子宫体部收缩良好,质硬,子宫下段及宫颈柔软,出血比较迅猛,本科室从2007年1月至2010年5月对31例阴道顺产子宫下段收缩不良的产后出血患者,采用无齿卵圆钳钳夹子宫颈及下段联合欣母沛等治疗,报告如下。
1 资料和方法
11 一般资料
产后出血患者54例,随机分为2组:观察组31例,年龄24～45岁,平均324岁;孕周33～39周,平均362周;边缘性前置胎盘5例;初产妇22例,经产妇9例。对照组24例,年龄23～42岁,平均307岁;孕周34～39周,平均371周;边缘性前置胎盘2例;初产妇17例,经产妇7例。2组产妇年龄、孕周、妊娠并发症等比较差异均无统计学意义(均 P>005)。
12 治疗方法
在胎儿娩出后立即静脉滴注缩宫素10U,胎盘娩出后常规按摩子宫,观察子宫收缩情况,检查胎盘胎膜的完整性及宫颈、软产道有无裂伤等,注意患者宫体部收缩情况,对于宫体部收缩良好但子宫下段柔软且阴道流血迅猛者为观察对象。对照组采取按摩子宫、静脉注射缩宫素、开放静
作者单位:518106深圳市公明人民医院 ......
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