双侧子宫动脉上行支结扎联合米索前列醇在产后出血患者中应用及对凝血因子影响.docVIP

双侧子宫动脉上行支结扎联合米索前列醇在产后出血患者中应用及对凝血因子影响 　　[摘要]目的 探?双侧子宫动脉上行支结扎联合米索前列醇在产后出血患者中的应用及对凝血因子的影响。方法 选取2015年10月～2016年10月我院收治的68例产后出血患者作为研究对象，采用随机数字表法将其分为两组，每组各34例。对照组患者实施B-Lynch缝合术治疗，观察组患者实施双侧子宫动脉上行支结扎联合米索前列醇治疗，于治疗前后行凝血因子检测，比较两组患者的止血效果、术后恢复情况及并发症发生情况。结果 观察组患者的止血成功率高于对照组，出血量、输血量少于对照组，手术时间、住院时间短于对照组，差异均有统计学意义（P0.05）。观察组患者的恶露暴露时间、产后月经周期短于对照组，月经复潮时间早于对照组，差异有统计学意义（P0.05）。治疗后，两组患者的AngⅡ、凝血因子Ⅷ、凝血因子Ⅸ水平高于本组治疗前，差异有统计学意义（P0.05）。观察组患者治疗后的AngⅡ、凝血因子Ⅷ、凝血因子Ⅸ水平高于对照组，差异有统计学意义（P0.05）。观察组患者的并发症总发生率低于对照组，差异有统计学意义（P0.05）。结论 双侧子宫动脉上行支结扎联合米索前列醇在产后出血患者中的应用效果显著，可明显改善凝血因子状况，有助于控制出血病情。 　　[关键词]米索前列醇；产后出血；凝血因子；影响 　　[中图分类号] R714.461 [文献标识码] A [文章编号] 1674-4721（2017）12（c）-0066-04 　　[Abstract]Objective To investigate the application of bilateral ascending uterine artery ligation combined with Misoprostol in patients with postpartum hemorrhage and its effect on coagulation factor.Methods 68 patients with postpartum hemorrhage treated in our hospital from October 2015 to October 2016 were selected as subjects and were divided into two groups by random number table method，34 cases in each group.The patients of control group were treated with B-Lynch suture，while the patients of observation group were treated with bilateral ascending uterine artery ligation combined with Misoprostol.Coagulation factor were detected before and after the treatment.Hemostatic effect，postoperative recovery and complications were compared between two groups.Results The success rate of hemostasis in the observation group was higher than that in the control group，the amount of bleeding and blood transfusion were less than those in the control group，the operation time and the length of hospital stay were shorter than those in the control group，and the differences were statistically significant （P 　　[Key words]Misoprostol；Postpartum hemorrhage；Coagulation factor；Influence 　　产后出血是临床产科的一种常见并发症，具有病情凶险、进展快、危险度高等特点，如果不能给予患者及时有效的临床治疗，病情将进一步进展，并引发多种严重并发症，进而危及患者的生命[1-2]。目前，临床主要采用B-Lynch缝合术、双侧子宫动脉上行支结扎等手术方式治疗，但手术疗效不一[3-4]，选用何种手术方式治疗产后出血，并确保安全