子宮B—lynch縫合防治剖宮產宮縮乏力性產后出血的臨床療效分析

[摘要] 目的 探討子宮B-lynch縫合聯合卡貝縮宮素或卡前列素氨丁三醇在剖宮產術中子宮收縮乏力產婦中應用的臨床效果分析。方法 從2012年1月—2015年12月期間選取存在產后出血高危因素剖宮產產婦70例，隨機分為觀察組（卡貝縮宮素或卡前列素氨丁三醇應用后予以子宮B-lynch縫合）和對照組（傳統治療聯合卡貝縮宮素或卡前列素氨丁三醇），各35例，比較兩組治療后臨床效果、術中和術后各指標情況。結果 觀察組顯效率80.0%、總有效率97.1%高于對照組37.1%、57.1%，差異具有統計學意義（P<0.05）；觀察組術中出血（565.38±208.83）mL、手術時間（50.32±16.79）min、術中輸血量（251.36±136.28）mL、產后2 h出血量（400.72±60.32）mL、產后24 h出血量（520.14±50.40）mL、住院時間（5.35±0.35）d均少于對照組，差異具有統計學意義（P<0.05）；產褥感染5.7%低于對照組25.7%，差異具有統計學意義（P<0.05）。結論 子宮B-lynch縫合聯合卡貝縮宮素或卡前列素氨丁三醇防治剖宮產術中子宮收縮乏力性產后出血臨床效果較好，術中和術后指征均恢復較好，適合臨床廣泛推廣。

[關鍵詞] 子宮B-lynch縫合；卡貝縮宮素；卡前列素氨丁三醇；剖宮產；子宮收縮乏力；產后出血

[中圖分類號] R983 [文獻標識碼] A [文章編號] 1674-0742（2016）11（c）-0104-04

[Abstract] Objective To study the uterine B-Lynch suture combined with Cabernet oxytocin or card prostacyclin ammonia butyl alcohol three in the Caesarean birth operation in uterine contraction fatigue of maternal clinical effect analysis. Methods During the period from January 2012 to December 2015 selects postpartum hemorrhage risk factors for cesarean section parturients in 70 cases， were randomly divided into observation group （carbetocin or card carboprost tromethamine application be B-Lynch uterine suture） and control group （conventional treatment combined with carbetocin or card carboprost tromethamine）， 35 cases in each， were compared between the two groups after treatment the clinical effect， intraoperative and postoperative indexes. Results The effective rate of observation group was 80.0%， the total efficiency of 97.1% higher than that of the control group 31.1%， 57.1%， the difference has statistical significance （P < 0.05）； observation group was bleeding （565.38±208.83）mL， operation time （50.32±16.79）min， intraoperative blood transfusion volume （251.36± 136.28）mL， 2 h post partum hemorrhage volume （400.72±60.32）mL， 24 h postpartum hemorrhage volume （520.14±50.40）mL， hospitalization time （5.35±0.35）d were less than the control group， the difference has statistical significance（P < 0.05）； puerperal infection 5.7% lower than 25.7% in control group， the difference is statistically significant （P < 0.05）. Conclusion Uterine B-Lynch suture combined with Cabernet oxytocin or card prostaglandin tromethamine treatment of cesarean section production operation in uterine contraction atony postpartum hemorrhage clinical effect better， intraoperative and postoperative refers to the syndrome were recovered well， suitable for clinical application.

[Key words] Uterine B-Lynch suture； Carbetocin； Carboprost tromethamine card； Cesarean section； Uterine atony； Postpartum hemorrhage

剖宮產是目前較多產婦會選擇的分娩方式，但其發生產后出血概率相對較高，尤其隨著近年來輔助生育技術的廣泛開展，多胎妊娠發生率明顯提高，子宮過度膨脹，子宮肌纖維伸展過度，容易導致產后宮縮乏力，剖宮產術中一旦出血即兇猛，不易控制，能在短時間內由于失血過多導致低血容量休克，甚至危及生命，因此，產后出血是產婦首要死亡原因，及時、有效的預防、搶救措施對挽救產婦生命意義重大[1]。……