宮腔水囊壓迫聯合米索前列醇治療剖宮產術中止血困難病例的療效研究

科研項目 韶關市衛生局科技立項項目(編號WSTJJ 2009 1102 3601 2219 7612 2639 69)

摘 要 目的:評價宮腔水囊壓迫聯合米索前列醇治療剖宮產術中止血困難的病例療效。方法:選擇剖宮產術中止血困難的病例20例，將其隨機分為兩組，各10例，分別采用宮腔水囊壓迫聯合米索前列醇(研究組)和宮腔水囊壓迫(對照組)治療。研究組手術前30分鐘予米索前列醇200μg舌下含服，臺上先予米索前列醇400μg溶碘皮膚黏膜消毒液置宮腔，自制水囊送入宮底部，注入生理鹽水至宮腔不出血為止，一般注入300ml即可達到止血效果，12小時后取出。為預防術后繼發性宮縮乏力性出血，術后再予米索前列醇200μg舌下含服，每6小時1次，3次;對照組僅采用水囊壓迫止血，水囊放置方法與研究組中的相同;比較兩組術中及產后2小時及24小時出血量、產后出血發病率、產后24小時血紅蛋白下降值。結果:研究組術中及產后2小時出血量、產后24小時出血量、產后24小時血紅蛋白下降值均低于對照組，差異均有統計學意義(P<0.05);研究組產后出血發病率明顯低于對照組(P<0.05)。結論:宮腔水囊壓迫聯合米索前列醇治療法操作簡便，止血迅速，效果確切，取材容易，成功率高，適用于各級醫院。

關鍵詞 宮腔水囊壓迫 米索前列醇 止血

doi:10.3969/j.issn.1007-614x.2010.22.086

Uterine water bag oppression combination of misoprostol in the treatment of cesarean section in cases of bleeding difficult curative effect

The Hospital of Shaoguan occupational-disease-prevention gynecology and obstetrics

Guoxiaoling Liurongjun Wuyuping

AbstractObjective:to evaluate the oppression of uterine water bag joint of misoprostol in the treatment of cesarean section in cases of bleeding difficult curative effect.Methods:select cesarean section of bleeding difficult cases，20 cases were randomly divided into groups and each group，10 cases were used respectively，water bag oppression joint misoprostol(group)and effective water bag oppression (control group).The half an hour before the surgery to 200μg misoprostol under the tongue，stage in 400μg misoprostol dissolve detergent for skin mucous membrane of iodine，uterine water bag into the palace，and injected saline water at the bottom of uterine bleeding，generally not to inject 300ml bleeding effect，after 12 hours.To preent postoperatie secondary contractions fatigue sex，postoperative bleeding to 200μg misoprostol under the tongue q6h under 3x，Only by water control，water bag no bleeding in the same place with the research method，Compare two sets of intraoperatie bleeding and postpartum 2h 24h and the incidence of postpartum hemorrhage，and postpartum 24h hemoglobin decline.Results:The bleeding and postpartum 2h intraoperatie bleeding， postpartum 24h，postpartum 24h hemoglobin decline in the value of a statistically significant difference(P<0.05).The incidence of postpartum hemorrhage obviously lower than those of the control group(P<0.05).Conclusion:effective water bag oppression joint misoprostol therapy，simple operation，hemostatic effect，rapid，exact to high success rate，suitable for various each layer of the hospital.

Key WordsUterine water bag oppression;Misoprostol;Bleeding