阿卡前列素氨丁三醇联合B-Lynch缝合治疗剖宫产产后大出血效果观察

目的 探讨卡前列素氨丁三醇联合B-Lynch缝合治疗剖宫产产后大出血的临床效果.方法 选择2012年1月至2015年6月本院收治的剖宫产术后大出血患者80例,按照随机数字法分为两组,各40例,对照组行B-Lynch缝合,观察组使用卡前列素氨丁三醇宫体注射联合B-Lynch缝合,比较两组手术及术后恢复情况、产后出血量、术后24h血小板计数及D-二聚体水平,并统计治疗期间发生的不良反应.结果 观察组患者手术时间为(52.8±11.7) min,短于对照组的(60.3± 13.4) min(P＜0.05),术后恶露持续时间为(15.6±2.8)d,短于对照组的(25.6±3.7)d(P＜0.05),月经恢复时间为(5.3±1.2)月,早于对照组的(6.7±1.8)月(P＜0.05),观察组产后2h出血量为(86.5±15.2) ml及产后24h出血量为(70.8±11.7) ml,均显著少于对照组的(100.8±19.1) ml和(150.3±13.3) ml(均P＜ 0.05),术后24 h观察组血小板计数为(158.6±25.7)×109/L,高于对照组的(89.5±11.1) ×109/L(P＜0.05),D-二聚体水平为(0.6±0.1)μg/ml,低于对照组的(3.1±0.5) μg/ml (P＜0.05).观察组发生恶心呕吐和血压升高的比例显著低于对照组(均P＜ 0.05).结论 卡前列素氨丁三醇宫体注射联合B-Lynch缝合能有效减少剖宫产术后大出血量,减少术中不良反应,促进患者术后康复.

Carboprost tromethamine combined with B-Lynch suture for postpartum hemorrhage

Objective To investigate the effect of carboprost tromethamine combined with B-Lynch suture for postpartum hemorrhage.Methods 80 patients with hemorrhage after cesarean section treated at our hospital from January,2012 to June,2015 were selected and were randomly divided into a control group and an observation group,40 for each group.The control group were treated by B-Lynch suture and the observation group were treated with carboprost tromethamine and B-Lynch suture.The surgical and postoperative recovery conditions,postpartum hemorrhage,postoperative 24 hours platelet count,and D-dimer level were compared between these two groups.The incidence of adverse reactions during treatment was calculated.Results The operation time,the duration of postoperative lochia,the menstruation recovery time,the bleeding volume 2 hours delivery,the bleeding volume 24 hours after delivery,the platelet count 24 hours after the operation,and the D-dimer level were (52.8±11.7) min,(15.6±2.8) d,(5.3±1.2) months,(86.5±15.2) ml,(70.8±11.7)ml,(158.6±25.7) × 109/L,and (0.6±0.1)μg/ml in the observation group and were (60.3±13.4)min,(25.6±3.7)d,(6.7±1.8) months,(100.8±19.1) ml,(89.5±11.1) ×l09/L,and (3.1±0.5) μg/ml in the control group (all P ＜ 0.05).The incidences of nausea and vomiting and high blood pressure were significantly lower in the observation group than in the control group (all P ＜ 0.05).Conclusions Carboprost tromethamine combined with B-Lynch suture can effectively reduce the bleeding volume after cesarean section and intra-operative adverse reactions,so it can promote the patients' postoperative rehabilitation.