卡前列甲酯栓联合缩宫素治疗瘢痕子宫合并前置胎盘再次剖宫产对产后出血的影响

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目的观察卡前列甲酯栓联合缩宫素对瘢痕子宫合并前置胎盘再次剖宫产产后出血的影响。方法将164例瘢痕子宫合并前置胎盘再次行剖宫产术患者随机分为研究组和对照组各82例。研究组予以卡前列甲酯栓加缩宫素进行治疗,对照组予以米索前列醇加缩宫素进行治疗。对比2组产后出血率,术中、产后2h与1d出血量和剖宫产前后血红蛋白(Hb)水平。结果研究组产后出血率为2.4%(2/82)低于对照组的11.0%(9/82),差异具有统计学意义(P<0.05)。2组剖宫产术中出血量差异无统计学意义(P>0.05)。2组产后2h、1d出血量均少于术中出血量,且研究组产后2h和产后1d出血量均少于对照组,差异均有统计学意义(P<0.05)。剖宫产前2组患者Hb水平差异无统计学意义(P>0.05)。剖宫产产后,2组患者Hb水平均低于产前,且研究组降低幅度小于对照组,差异有统计学意义(P<0.05)。结论卡前列甲酯栓联合缩宫素可有效降低瘢痕子宫合并前置胎盘再次剖宫产产后出血,临床价值较高。 Objective To observe the effect of cardioprotection combined with oxytocin on cesarean section post-cesarean section with scarring uterus and placenta previa. Methods One hundred and sixty-four patients with scar uterus and placenta previa were randomly divided into study group and control group with 82 cases in each group. The study group was treated with prostaglandin ester suppository and oxytocin, while the control group was treated with misoprostol plus oxytocin. The postpartum hemorrhage rate, intraoperative, 2h and 1d postpartum hemorrhage volume and hemoglobin (Hb) level before and after cesarean section were compared. Results The rate of postpartum hemorrhage in study group was 2.4% (2/82), which was lower than that in control group (11.0%, 9/82). The difference was statistically significant (P <0.05). There was no significant difference in bleeding volume between the two groups in cesarean section (P> 0.05). The amount of bleeding in 2 h and 1 d postpartum was less than that in operation, and the amount of bleeding in study group 2 h postpartum and 1 d postnatal was less than that in control group (P <0.05). There was no significant difference in Hb level between the two groups before cesarean section (P> 0.05). After cesarean section, the levels of Hb in both groups were lower than those in prenatal period, and the decrease in study group was smaller than that in control group (P <0.05). Conclusions Cardinal methylester suppository combined with oxytocin can effectively reduce the post-cesarean section bleeding after scarring uterus with placenta previa and has high clinical value.
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