球囊填塞或宫腔碘仿纱条联合卡前列素氨丁三醇宫体注射对前置胎盘产妇剖宫产出血的干预效果

目的探讨球囊填塞或宫腔碘仿纱条联合卡前列素氨丁三醇宫体注射对前置胎盘产妇剖宫产出血的干预效果。方法回顾性分析本院2016年1月至2019年12月收治的82例行剖宫术的前置胎盘产妇的临床资料,依照填塞方式将采用宫腔碘仿纱条填塞的40例产妇纳入宫腔碘仿纱条组,将采用宫腔球囊填塞术的42例产妇纳入宫腔球囊组。两组产妇均给予宫体注射卡前列素氨丁三醇。比较两组产妇手术不同时间的出血量、血气指标、不良事件发生情况、恶露持续时间及首次月经恢复时间。结果术中及术后2、24 h,宫腔球囊组的出血量均少于宫腔碘仿纱条组(P<0.05)。术后,两组的Hb、PLT水平均降低,但宫腔球囊组高于宫腔碘仿纱条组(P<0.05);术后,两组的SpO2、CVP水平比较,差异无统计学意义(P>0.05)。两组的子宫切除、产褥感染、失血性休克、弥散性血管内凝血发生率比较,差异无统计学意义(P>0.05)。两组的恶露持续时间、首次月经恢复时间比较,差异无统计学意义(P>0.05)。结论球囊填塞联合卡前列素氨丁三醇宫体注射对前置胎盘产妇剖宫产出血的止血效果优于宫腔碘仿纱条填塞。

Intervention effect of balloon packing or uterine iodoform gauze combined with carboprost tromethamine intrauterine injection on cesarean section hemorrhage of placenta previa parturients

Objective To investigate the intervention effect of balloon packing or uterine iodoform gauze combined with carboprost tromethamine intrauterine injection on cesarean section hemorrhage of placenta previa.Methods The clinical data of 82 parturients with placenta previa who underwent cesarean section in our hospital from January 2016 to December 2019 were retrospectively analyzed.According to the packing method,40 parturients who used uterine iodoform gauze were included in the uterine iodoform gauze group,and 42 parturients who used uterine balloon tamponade were included in the uterine balloon group.Both groups were given carboprost tromethamine intrauterine injection.The bleeding volume at different times of operation,blood gas indicators,adverse events,the duration of lochia and the recovery time of the first menstruation of pregnant women of the two groups were compared.Results During the operation and 2,24 h after the operation,the bleeding volume of the uterine balloon group were less than those of the uterine iodoform gauze group(P<0.05).After operation,the levels of Hb and PLT in the two groups decreased,but those in the uterine balloon group were higher than those in the uterine iodoform gauze group(P<0.05);after operation,there were no significant differences in SpO2 and CVP levels between the two groups(P>0.05).There were no significant differences in the incidences of hysterectomy,puerperal infection,hemorrhagic shock and diffuse intravascular coagulation between the two groups(P>0.05).There were no significant differences in the duration of lochia and the recovery time of the first menstruation between the two groups(P>0.05).Conclusion Balloon packing combined with carboprost tromethamine intrauterine injection for cesarean section hemorrhage of placenta previa parturients has better hemostatic effect compared with uterine iodoform gauze packing.