可充气加压式子宫帽的制作与应用

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目的:介绍一种可充气加压式子宫帽,分析其在剖宫产术中产后出血的应用价值。方法选取2012年7月—2014年5月于顺德龙江医院妇产科住院并在剖宫产术中发生产后出血的患者124例,采用简单随机化法分为治疗组(62例)和对照组(62例)。治疗组患者应用可充气加压式子宫帽止血,对照组患者应用药物(卡前列素氨丁三醇注射液、米索前列醇、卡前列甲酯栓等)止血。评价两组患者产后24 h出血量、输血情况(输血例数、输血量)、住院时间、术后病率、术后抗生素使用时间、血性恶露时间。结果治疗组和对照组止血有效率分别为100.0%(62/62)、90.3%(56/62),差异有统计学意义(χ2=4.379,P=0.036)。治疗组患者产后24 h出血量、输血例数、术后病率低于对照组( P<0.05)。两组患者输血量、住院时间、术后抗生素使用时间、血性恶露时间比较,差异无统计学意义(P>0.05)。结论可充气加压式子宫帽操作简单,见效快,止血效果好,建议可作为剖宫产术中产后出血一线药物治疗后的首选治疗方法,尤其适用于宫缩乏力性产后出血。“,”Objective To introduce an inflatable pressurized uterine cap,to analyse its application value in treatment of postpartum hemorrhage after cesarean section. Methods 124 patients who had postpartum hemorrhage after cesarean section in Gynaecology and Obstetrics. Department of Shunde Longjiang Hospital from July 2012 to May 2014,were divided into treatment group(62 cases ) and control group ( 62 cases ) by simple randomization method. In order to stop bleeding, patients in treatment group were treated with inflatable pressurized uterine cap,patients in control group were treated with drugs( hemabate, Misoprostol,Carboprost,et al). The volume of hemorrhage 24 hours after parturition,the situations of blood transfusion( the number of cases of blood transfusion,blood transfusion amount),hospitalization time,postoperative morbidity,postoperative use of antibiotics,and duration of bloody lochia were compared between two groups. Results There was significant difference in effective rate of haemostasis between treatment group and the control group〔100. 0%( 62/62 ) vs. 90. 3%( 56/62 ),χ2=4. 379,P=0. 036〕. The volume of hemorrhage 24 hours after parturition,the number of cases of blood transfusion and postoperative morbidity in treatment group was significantly fewer or lower than that in control group,respectively(P0. 05 ) . Conclusion Inflatable pressurized uterine cap has the advantages of simple operation,quick effectiveness and good hemostatic effect. After the first -line drug treatment,the study recommends that it can be used as the preferred treatment for postpartum hemorrhage after cesarean section,it is especially suitable for postpartum hemorrhage due to uterine inertia.
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