剖宫产术中卡孕栓舌下含化联合短时间宫腔填塞预防产后出血的意义

目的:探讨卡孕栓舌下含化联合短时间宫腔填塞在剖宫产术中对产后出血的预防作用。方法:183例产后出血患者分为对照组43例和治疗组140例,均给予催产素、子宫按摩和卡孕栓等常规方法止血。治疗组在胎盘娩出后立即宫腔填塞纱布垫,同时迅速缝合子宫切口;对照组在胎盘娩出后按常规缝合子宫切口,根据子宫收缩情况决定是否给予其他促子宫收缩的方法,如B-Lynch缝合术或(和)子宫肌注欣母沛。结果:治疗组术中及产后2 h出血量均少于对照组(P<0.05),产后24 h血红蛋白量明显高于对照组(P<0.05);无继发的产后出血及产褥感染,避免了子宫切除。结论:卡孕栓联合短时间宫腔填塞在剖宫产术中的应用简单、安全、快速、经济、有效,是预防手术中产后出血和保留子宫的有效方法之一,尤其值得在基层医院推广使用。

Significance of sublingual administration of Carboprost combined with short time intrauterine packing during cesarean section for preventing postpartum hemorrhage

Objective:To explore the effect of sublingual administration of Carboprost combined with short time intrauterine packing during cesarean section for preventing postpartum hemorrhage.Methods:A total of 183 patients with postpartum hemorrhage were divided into control group(43 patients) and treatment group(140 patients),the patients in the two groups were treated with conventional methods(oxytocin,uterine massage,and Carboprost) to stop bleeding.The patients in treatment group were treated with intrauterine packing with gauze after delivery of placenta immediately,at the same time,uterine incision was sutured quickly;the uterine incision of patients in control group were sutured conventionally,other methods promoting uterine contraction were applied according to the situation of uterine contraction,such as B-Lynch suture or/and uterine intramuscular injection of Hemabate.Results:The volumes of bleeding during operation and at two hours after delivery in treatment group were statistically significantly less than those in control group(P<0.05),the content of hemoglobin at 24 hours after delivery in treatment group was statistically significantly higher than that in control group(P<0.05);no subsequent postpartum hemorrhage and puerperal infection occurred,uterectomy was avoided.Conclusion:Carboprost combined with short time intrauterine packing during cesarean section is simple,safe,rapid,economic,and effective,which is one of effective methods to prevent postpartum hemorrhage and preserve uterus,and the method is worthy to be popularized and used in grass-roots hospitals.