卡前列素氨丁三醇联合纱条宫内填塞治疗前置胎盘疗效探讨.docVIP

卡前列素氨丁三醇联合纱条宫内填塞治疗前置胎盘疗效探讨 　　[摘要] 目的 探讨卡前列素氨丁三醇联合纱条宫内填塞治疗前置胎盘的疗效。 方法 选取该院前置胎盘的孕妇患者40例，行卡前列素氨丁三醇联合纱条宫内填塞治疗，根据患者的临床资料和随访记录进行回顾性分析。 结果 40例患者经过上述治疗处理后，36例（80%）出血量2 000 mL；2例患者出血量在2 000～3 000 mL之间者，行子宫动脉结扎止血；2例患者因出血量接近4 000 mL行全子宫切除，无死亡病例。术后成功随访，均未发现切口感染、盆腔感染或晚期产后出血。与对照组对比，差异有统计学意义，P0.05。结论 应用卡前列素氨丁三醇加宫腔填塞纱条压迫止血是治疗前置胎盘产后出血的有效方法，效果明显、简单方便、可操作性强，建议临床推广应用。 　　[关键词] 前置胎盘；卡前列素氨丁三醇；纱条宫内填塞 　　[中图分类号] R719 [文献标识码] A [文章编号] 1674-0742（2014）08（b）-0027-02 　　[Abstract] Objective To investigate the effects of Carboprost tromethamine combined with intrauterine packing with gauze in the treatment of placenta previa. Methods 40 pregnant patients with placenta previa admitted in our hospital were selected and given the treatment of Carboprost tromethamine combined with intrauterine packing gauze， and were analyzed retrospectively according to the clinical data and follow-up records of the patients. Results After the above treatment， of the 40 patients， the amount of bleeding of 36 patients（80%） was less than 2000 ml； and 2 patients with the amount of bleeding between 2000-3000ml were given the uterine artery ligation for hemostasis； 2 patients underwent hysterectomy due to the amount of bleeding was close to 4000ml； there was no death case. No incision infection， pelvic infection and late postpartum hemorrhage were found during the successfully postoperative follow up. Compared with the control group， the differences were statistically significant， P0.05. Conclusion Carboprost tromethamine combined with intrauterine packing with gauze is an effective method for postpartum placenta previa bleeding， its effect is significant， the operation is simple and convenient with strong operability， so it deserves to be applied clinically. 　　[Key words] Placenta previa； Carboprost tromethamine； Intrauterine packing with gauze 　　正常妊娠时胎盘附着于子宫体部的前壁、后壁或者侧壁。妊娠28周后，若胎盘附着于子宫下段、下缘达到或覆盖宫颈内口，位置低于胎先露部，称为前置胎盘。前置胎盘是妊娠晚期严重并发症之一，也是妊娠晚期阴道流血最常见的原因。其发病率国外报道0.5%，国内报道0.24%～1.57%[1]。该研究为卡前列素氨丁三醇联合纱条宫内填塞治疗前置胎盘的疗效，对200