妇产与遗传（电子版）
婦產與遺傳（電子版）
부산여유전（전자판）
Obstetrics-Gynecology and Genetics(Electronic Edition)
2014年
1期
37-40
,共4页
欣母沛%碘仿纱%前置胎盘%剖宫产%产后出血
訢母沛%碘倣紗%前置胎盤%剖宮產%產後齣血
흔모패%전방사%전치태반%부궁산%산후출혈
Hemabate%Iodoform gauze%Placenta previa%Cesarean section%Postpartum hemorrhage
目的：探讨子宫肌层注射欣母沛（卡前列素氨丁三醇）联合宫腔填塞碘仿纱预防前置胎盘剖宫产术后出血的临床疗效。方法回顾性分析2009年2月~2012年1月因前置胎盘行剖宫产术并且术中出现宫缩乏力及剥离面严重渗血的患者共120例，分为研究组及对照组各60例。研究组采用在静脉点滴缩宫素的基础上于子宫肌层注射欣母沛联合宫腔填塞碘仿纱。对照组采用常规的静脉点滴缩宫素及子宫肌层注射缩宫素联合出血点缝扎，观察两组患者产后出血情况。结果研究组59例剖宫产产妇未出现产后出血，仅1例患者因胎盘粘连严重，出现产后2小时内大出血，量约1800 ml，经保守治疗后症状好转，所有患者均于术后24 h顺利取出纱条。对照组出现产后出血患者共有11例，6例经保守治疗后成功止血，5例行全子宫切除术。研究组的产后出血发生率为1.67%，明显低于对照组18.33%（χ2=9.26，P<0.01），差异有统计学意义。研究组术中（t=11.95，P<0.01）、产后2 h（t=18.43，P<0.01）和产后24 h（t=13.56，P<0.01）平均出血量也均明显少于对照组，差异有统计学意义。所有患者均无晚期子宫出血发生，无腹部切口及宫腔感染发生，随访3~6个月，子宫复旧良好。结论子宫肌注射欣母沛联合宫腔填塞碘仿纱是治疗前置胎盘产后出血的有效手段，值得临床推广应用。
目的：探討子宮肌層註射訢母沛（卡前列素氨丁三醇）聯閤宮腔填塞碘倣紗預防前置胎盤剖宮產術後齣血的臨床療效。方法迴顧性分析2009年2月~2012年1月因前置胎盤行剖宮產術併且術中齣現宮縮乏力及剝離麵嚴重滲血的患者共120例，分為研究組及對照組各60例。研究組採用在靜脈點滴縮宮素的基礎上于子宮肌層註射訢母沛聯閤宮腔填塞碘倣紗。對照組採用常規的靜脈點滴縮宮素及子宮肌層註射縮宮素聯閤齣血點縫扎，觀察兩組患者產後齣血情況。結果研究組59例剖宮產產婦未齣現產後齣血，僅1例患者因胎盤粘連嚴重，齣現產後2小時內大齣血，量約1800 ml，經保守治療後癥狀好轉，所有患者均于術後24 h順利取齣紗條。對照組齣現產後齣血患者共有11例，6例經保守治療後成功止血，5例行全子宮切除術。研究組的產後齣血髮生率為1.67%，明顯低于對照組18.33%（χ2=9.26，P<0.01），差異有統計學意義。研究組術中（t=11.95，P<0.01）、產後2 h（t=18.43，P<0.01）和產後24 h（t=13.56，P<0.01）平均齣血量也均明顯少于對照組，差異有統計學意義。所有患者均無晚期子宮齣血髮生，無腹部切口及宮腔感染髮生，隨訪3~6箇月，子宮複舊良好。結論子宮肌註射訢母沛聯閤宮腔填塞碘倣紗是治療前置胎盤產後齣血的有效手段，值得臨床推廣應用。
목적：탐토자궁기층주사흔모패（잡전렬소안정삼순）연합궁강전새전방사예방전치태반부궁산술후출혈적림상료효。방법회고성분석2009년2월~2012년1월인전치태반행부궁산술병차술중출현궁축핍력급박리면엄중삼혈적환자공120례，분위연구조급대조조각60례。연구조채용재정맥점적축궁소적기출상우자궁기층주사흔모패연합궁강전새전방사。대조조채용상규적정맥점적축궁소급자궁기층주사축궁소연합출혈점봉찰，관찰량조환자산후출혈정황。결과연구조59례부궁산산부미출현산후출혈，부1례환자인태반점련엄중，출현산후2소시내대출혈，량약1800 ml，경보수치료후증상호전，소유환자균우술후24 h순리취출사조。대조조출현산후출혈환자공유11례，6례경보수치료후성공지혈，5례행전자궁절제술。연구조적산후출혈발생솔위1.67%，명현저우대조조18.33%（χ2=9.26，P<0.01），차이유통계학의의。연구조술중（t=11.95，P<0.01）、산후2 h（t=18.43，P<0.01）화산후24 h（t=13.56，P<0.01）평균출혈량야균명현소우대조조，차이유통계학의의。소유환자균무만기자궁출혈발생，무복부절구급궁강감염발생，수방3~6개월，자궁복구량호。결론자궁기주사흔모패연합궁강전새전방사시치료전치태반산후출혈적유효수단，치득림상추엄응용。
Objective To study the clinical curative effect of Hemabate combined with intrauterine tamponade iodoform gauze in preventing postoperative hemorrhage from placenta previa. Method 120 patients with cesarean section due to placenta previa and occurred intraoperative uterine inertia and bleeding from February 2009 to January 2012 were analyzed retrospectively. They were randomly divided into research group and control group (n=60). The Research group were administered Hemabate combined with intrauterine tamponade iodoform gauze on the basis of intravenous oxytocin, and the control group were given conventional myometrium injection of oxytocin and intravenous oxytocin combined with suture bleeding. The postpartum hemorrhage of both groups was observed.research groupResearch group. Results There only one case in the research group occurred postpartum hemorrhage within 2 hours postoperatively because of placenta accrete, and all the patients of the observation group were taken out the gauze 24 hours after surgery successfully. There were 11 patients in the control group occurred postpartum hemorrhage of whom 6 were successful hemostasis after conservative treatment and 5 underwent hysterectomy. The incidence of postpartum hemorrhage of research group was 1.67%, and significantly lower than the control group 18.33%,(χ2=9.26,P<0.01), the difference was statistically significant. The volume of average blood loss of research group intraoperative (t=11.95, P<0.01), postpartum 2 h (t=18.43, P<0.01) and postpartum 24 h (t=13.564, P<0.01) were significantly less than the control group,The difference was statistically significant. All 120 patients didin't occur late postpartum hemorrhage and abdominal incision and uterine infections. All were followed up for 3 to 6 months, and the involution of uterus was good. Conclusions The clinical curative effect of Hemabate combined with intrauterine tamponade iodoform gauze is an effective means to preventpostoperative hemorrhage from placenta previa.
