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[摘要] 目的 观察欣母沛联合宫腔填纱治疗前置胎盘剖宫产产后出血的效果。 方法 将2015年2月～2016年2月入住我院的前置胎盘剖宫产患者60例作为观察对象，根据治疗方法不同分为对照组与观察组，每组30例。两组均行宫腔填纱治疗，其中观察组加用欣母沛治疗，对照组加用米索前列醇治疗。比较两组用药后2 h、12 h、24 h的产后出血量，观察两组患者治疗前后血红蛋白的变化情况。 结果 觀察组用药后2 h、12 h、24 h的产后出血量均显著少于对照组，差异具有统计学意义（P<0.05）。治疗前观察组与对照组Hb 水平比较，差异无统计学意义（P>0.05）；治疗后观察组与对照组的Hb 水平均降低，但对照组降低幅度大（P<0.05）。 结论 欣母沛联合宫腔填纱治疗前置胎盘剖宫产产后出血效果好，可以降低产后出血量，值得推广和应用。
[关键词] 前置胎盘；剖宫产；产后出血；欣母沛；宫腔填纱
[中图分类号] R714.461 [文献标识码] B [文章编号] 1673-9701（2017）02-0042-03
Clinical observation of hemabate combined with uterine packing in treatment of placenta previa postpartum hemorrhage of cesarean section
XU Fuyan
Department of Gynecology and Obstetrics， Zibo Mining Group Co.， Ltd Central Hospital， Zibo 255120， China
[Abstract] Objective To observe the effect of hemabate combined with uterine packing in treatment of placenta previa postpartum hemorrhage of cesarean section. Methods From February 2015 to February 2016 in our hospital， selected 60 patients as the observation objects， according to the different treatment methods they were divided into control group and observation group， 30 cases in each group. Two groups were received intrauterine gauze packing treatment， the observation group was treated with hemabate， the control group was treated with misoprostol treatment. The amount of postpartum hemorrhage of 2 h， 12 h and 24 h between two groups after treatment and the changes of hemoglobin before and after treatment in two groups were compared. Results After treatment， the amount of postpartum hemorrhage of 2 h， 12 h and 24 h in observation group was significantly less than that in control group， and the difference was significant（P<0.05）. Before treatment， Hb level of observation group compared with the control group， the difference was not significant（P>0.05）； After treatment， the Hb levels of observation group and the control group were decreased， but the control group reduced more（P<0.05）. Conclusion The effect of hemabate combined with uterine packing in treatment of placenta previa postpartum hemorrhage of cesarean section is good， reduce amount of postpartum hemorrhage， worthy of promotion and application.
[Key words] Placenta previa； Cesarean section； Postpartum hemorrhage； Hemabate； Uterine packing
前置胎盘是产科常见的疾病之一，若治疗不及时，易引起产后出血，甚至导致产妇死亡[1]。对于前置胎盘产妇多采取剖宫产术，可以迅速结束分娩。但在剖宫产术中，易出现胎盘不能完全剥离或胎盘剥离面血窦不能紧缩关闭的现象，易发生产后出血。目前临床较多文献报道，欣母沛与缩宫素、宫腔填纱联合应用止血效果较好[2-6]。因此，本研究旨在观察欣母沛联合宫腔填纱治疗前置胎盘剖宫产产后出血的效果，现报道如下。
1 资料与方法 1.1 一般资料
将2015年2月～2016年2月入住我院的前置胎盘剖宫产患者60例作为观察对象，排除凝血功能障碍、严重肝肾功能异常、过敏体质者。患者年龄22～36岁，孕周36～41周，根据治疗方法不同分为对照组与观察组，每组30例。两组入选产妇的年龄、孕周、前置胎盘位置及病史等临床资料比较，差异均无统计学意义（P>0.05），具有可比性。两组产妇一般资料比较见表1。
1.2 治疗方法
1.2.1 对照组 应用宫腔填纱进行止血，准备无菌宫腔纱条，5%聚維酮碘液浸透并拧干。填塞时，采用卵圆钳将纱布从宫底填紧，在子宫切口位置留出一定长度，将纱布另一端置入阴道中，填塞产妇子宫下段，缝合切口。对照组在此基础上予米索前列醇 0.2 mg口服（湖北葛店人福药业有限责任公司，国药准字 H20073696）。
1.2.2 观察组 在对照组宫腔填纱止血的基础上加用欣母沛，即产妇娩出胎儿后，取欣母沛250 μg（Pharmacia
[关键词] 前置胎盘；剖宫产；产后出血；欣母沛；宫腔填纱
[中图分类号] R714.461 [文献标识码] B [文章编号] 1673-9701（2017）02-0042-03
Clinical observation of hemabate combined with uterine packing in treatment of placenta previa postpartum hemorrhage of cesarean section
XU Fuyan
Department of Gynecology and Obstetrics， Zibo Mining Group Co.， Ltd Central Hospital， Zibo 255120， China
[Abstract] Objective To observe the effect of hemabate combined with uterine packing in treatment of placenta previa postpartum hemorrhage of cesarean section. Methods From February 2015 to February 2016 in our hospital， selected 60 patients as the observation objects， according to the different treatment methods they were divided into control group and observation group， 30 cases in each group. Two groups were received intrauterine gauze packing treatment， the observation group was treated with hemabate， the control group was treated with misoprostol treatment. The amount of postpartum hemorrhage of 2 h， 12 h and 24 h between two groups after treatment and the changes of hemoglobin before and after treatment in two groups were compared. Results After treatment， the amount of postpartum hemorrhage of 2 h， 12 h and 24 h in observation group was significantly less than that in control group， and the difference was significant（P<0.05）. Before treatment， Hb level of observation group compared with the control group， the difference was not significant（P>0.05）； After treatment， the Hb levels of observation group and the control group were decreased， but the control group reduced more（P<0.05）. Conclusion The effect of hemabate combined with uterine packing in treatment of placenta previa postpartum hemorrhage of cesarean section is good， reduce amount of postpartum hemorrhage， worthy of promotion and application.
[Key words] Placenta previa； Cesarean section； Postpartum hemorrhage； Hemabate； Uterine packing
前置胎盘是产科常见的疾病之一，若治疗不及时，易引起产后出血，甚至导致产妇死亡[1]。对于前置胎盘产妇多采取剖宫产术，可以迅速结束分娩。但在剖宫产术中，易出现胎盘不能完全剥离或胎盘剥离面血窦不能紧缩关闭的现象，易发生产后出血。目前临床较多文献报道，欣母沛与缩宫素、宫腔填纱联合应用止血效果较好[2-6]。因此，本研究旨在观察欣母沛联合宫腔填纱治疗前置胎盘剖宫产产后出血的效果，现报道如下。
1 资料与方法 1.1 一般资料
将2015年2月～2016年2月入住我院的前置胎盘剖宫产患者60例作为观察对象，排除凝血功能障碍、严重肝肾功能异常、过敏体质者。患者年龄22～36岁，孕周36～41周，根据治疗方法不同分为对照组与观察组，每组30例。两组入选产妇的年龄、孕周、前置胎盘位置及病史等临床资料比较，差异均无统计学意义（P>0.05），具有可比性。两组产妇一般资料比较见表1。
1.2 治疗方法
1.2.1 对照组 应用宫腔填纱进行止血，准备无菌宫腔纱条，5%聚維酮碘液浸透并拧干。填塞时，采用卵圆钳将纱布从宫底填紧，在子宫切口位置留出一定长度，将纱布另一端置入阴道中，填塞产妇子宫下段，缝合切口。对照组在此基础上予米索前列醇 0.2 mg口服（湖北葛店人福药业有限责任公司，国药准字 H20073696）。
1.2.2 观察组 在对照组宫腔填纱止血的基础上加用欣母沛，即产妇娩出胎儿后，取欣母沛250 μg（Pharmacia