对比宫腔球囊填塞与B—Lynch缝合在治疗前置胎盘剖宫产术后出血的临床效果(1)
【摘 要】 目的：研究球囊宫腔填塞与B-Lynch缝合治疗前置胎盘剖宫产患者产后出血的临床效果。方法：将 成都市锦江区妇幼保健院2013 年 6 月 ～2015 年 6月实施剖宫产术的 55例前置胎盘患者作为研究，随机分为观察组和对照组，所有病例为非瘢痕子宫且不合并胎盘植入，两组患者均静脉滴注缩宫素，同时使用欣母沛进行止血(缩宫素 20 U + 卡前列素 250 μg 宫体注射)。观察组用球囊宫腔填塞，对照组用B-Lynch缝合。55例前置胎盘产妇分为对照组(30例)和观察组(25例)。计算两组术中及术后 2 和 24 h 总出血量，观察两组术后不良反应发生情况。结果：对照组和观察组术中出血量分别为(550±55)ml 和(505 ±26)ml，差异无统计学意义(P >0.05)；对照组和观察组术后 2 h 出血量分别为(120 ± 25)ml 和(15 ± 5)ml，差异有统计学意义(P < 0.05)；对照组和观察组术后 24 h 出血量分别为(802±45)ml 和(568 ± 27)ml，差异有统计学意义(P < 0.05)；两组产后出血量≥1 000 ml 共 6例，其中对照组 6例(20.00%，6/30)、观察组 2 例(8.00%，2/25)；两组均无子宫切除病例、无明显的不良反应。结论：宫腔球囊填塞技术治疗前置胎盘产妇剖宫产术中及术后出血有效、简便，效果优于B-Lynch 缝合，两组均无患者行子宫切除术，所有病例痊愈出院并随访 6 个月，无一例并发症发生。
【关键词】 球囊宫腔填塞；B-Lynch 缝合；前置胎盘剖宫产；术后出血
Abstract Objective：To study the uterine balloon tamponade and B-Lynch suture treatment of patients with placenta previa cesarean section postpartum hemorrhage clinical results.Methods：55 cases of patients with placenta previa will Chengdu Jinjiang MCH June 2013 - June 2015 the implementation of cesarean section as the study were randomly divided into two groups and the control group，and not in all cases the non-scarred uterus with placenta implantation，patients were intravenous infusion of oxytocin，while using Hemabate to stop bleeding(oxytocin 20 U + Carboprost 250 μg Palace injection).Uterine balloon tamponade with the observation group，the control group suture B-Lynch.55 cases of placenta previa women were divided into control group(30 cases)and observation group(25 cases).Calculation groups during and after 2 and 24 h of the total amount of bleeding observed postoperative adverse events.Results：In control group and observation group blood loss was(550 ± 55)ml and(505 ± 26)ml，the difference was not statistically significant(P> 0 05.)；Control group and observation group after 2 h bleeding the amount was(120 ± 25)ml and(15 ± 5)ml，the difference was statistically significant(P <0.05)；control group and observation group after 24 h blood loss was(802 ± 45)ml and(568 ± 27)ml，the difference was statistically significant(P <0.05)；two groups of postpartum hemorrhage ≥1 000 ml total of six cases，including six cases in the control group(20.00%，6/30)，was observed Group 2 patients(8.00%，2/25)；There were no cases of hysterectomy，no significant adverse reactions.Conclusion：The treatment of uterine balloon tamponade maternal placenta previa cesarean section and postoperative bleeding effective，simple，better than B-Lynch suture，were no patients underwent hysterectomy，all cases were discharged and followed up 6 months，no case of complications. (刘运芬 罗 琼 王 庆)
【关键词】 球囊宫腔填塞；B-Lynch 缝合；前置胎盘剖宫产；术后出血
Abstract Objective：To study the uterine balloon tamponade and B-Lynch suture treatment of patients with placenta previa cesarean section postpartum hemorrhage clinical results.Methods：55 cases of patients with placenta previa will Chengdu Jinjiang MCH June 2013 - June 2015 the implementation of cesarean section as the study were randomly divided into two groups and the control group，and not in all cases the non-scarred uterus with placenta implantation，patients were intravenous infusion of oxytocin，while using Hemabate to stop bleeding(oxytocin 20 U + Carboprost 250 μg Palace injection).Uterine balloon tamponade with the observation group，the control group suture B-Lynch.55 cases of placenta previa women were divided into control group(30 cases)and observation group(25 cases).Calculation groups during and after 2 and 24 h of the total amount of bleeding observed postoperative adverse events.Results：In control group and observation group blood loss was(550 ± 55)ml and(505 ± 26)ml，the difference was not statistically significant(P> 0 05.)；Control group and observation group after 2 h bleeding the amount was(120 ± 25)ml and(15 ± 5)ml，the difference was statistically significant(P <0.05)；control group and observation group after 24 h blood loss was(802 ± 45)ml and(568 ± 27)ml，the difference was statistically significant(P <0.05)；two groups of postpartum hemorrhage ≥1 000 ml total of six cases，including six cases in the control group(20.00%，6/30)，was observed Group 2 patients(8.00%，2/25)；There were no cases of hysterectomy，no significant adverse reactions.Conclusion：The treatment of uterine balloon tamponade maternal placenta previa cesarean section and postoperative bleeding effective，simple，better than B-Lynch suture，were no patients underwent hysterectomy，all cases were discharged and followed up 6 months，no case of complications. (刘运芬 罗 琼 王 庆)