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目的:探讨宫腔填塞联合米索前列醇预防高危因素剖宫产产后出血的临床疗效。方法:有剖宫产产后出血高危因素产妇125例,随机分为A组(n=63)和B组(n=62)。A、B组所有患者均于胎儿娩出后给予子宫壁肌肉内注射缩宫素20 U、静脉滴注缩宫素10 U,手术结束后给予肛塞米索前列醇400μg。但A组另于胎盘娩出、宫腔清理后给予纱布填塞宫腔。观察术中、术后2 h、术后24 h出血量及手术时间、产褥感染、不良反应情况。结果:A组术中、术后2 h、术后24 h出血量分别为:150.3±42.3 ml,282.2±55.2 ml,355.8±92.5 ml;产后出血率为1.59%;B组术中、术后2 h、术后24 h出血量分别为:206.7±33.9 ml,456.2±75.3 ml,568.4±83.2 m1;产后出血率为12.90%;A组出血量及产后出血发生率明显低于B组(P<0.05),而手术时间、产褥感染、不良反应情况组间无统计学差异(P>0.05)。结论:宫腔填塞纱布联合米索前列醇预防高危因素剖宫产产后出血疗效显著,可明显减少产后出血发生率。
Objective: To investigate the clinical efficacy of uterine plug combined with misoprostol in preventing high-risk caesarean section postpartum hemorrhage. Methods: 125 pregnant women with high risk of bleeding after cesarean section were randomly divided into group A (n = 63) and group B (n = 62). All patients in groups A and B were given intrauterine injection of oxytocin 20 U after intrauterine delivery and 10 U of oxytocin intravenously. After the operation, 400 μg of misoprostol was given to the anus. However, another group A was delivered in the placenta, uterine cavity to give gauze after packing the uterine cavity. The intraoperative, postoperative 2 h, 24 h postoperative bleeding and operation time, puerperal infection, adverse reactions. Results: The intraoperative, postoperative 2 h, postoperative 24 h hemorrhage were 150.3 ± 42.3 ml, 282.2 ± 55.2 ml and 355.8 ± 92.5 ml, respectively; the rate of postpartum hemorrhage was 1.59%. In group B, intraoperative and postoperative 2 h and 24 h after operation were 206.7 ± 33.9 ml, 456.2 ± 75.3 ml and 568.4 ± 83.2 m1, respectively. The rate of postpartum hemorrhage was 12.90%. The bleeding volume and the incidence of postpartum hemorrhage in group A were significantly lower than those in group B <0.05), but there was no significant difference between operation group, puerperal infection and adverse reaction group (P> 0.05). Conclusion: Intrauterine gauze gauze combined with misoprostol to prevent high risk factors for cesarean section postpartum hemorrhage significant effect, can significantly reduce the incidence of postpartum hemorrhage.