摘要
目的探究可吸收止血微球在前置胎盘剖宫产术中的应用效果。方法选取2018年1月至2021年3月海南省妇女儿童医学中心收治的80例行剖宫产术的前置胎盘孕妇,按照治疗方法不同分为观察组和对照组,每组40例。对照组采用常规预防性止血措施,观察组在对照组基础上加用可吸收止血微球治疗。比较2组患者术中和术后24 h出血量、出血时间、并发症发生率及子宫切除率,比较2组患者术前、术后24 h凝血功能[纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]及应激指标[去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)、血管紧张素Ⅱ(Ang-Ⅱ)]。结果观察组术中、术后24 h出血量均低于对照组(P<0.05),出血时间短于对照组(P<0.05)。术后24 h观察组APTT、PT、TT水平较对照组低(P<0.05),FIB水平较对照组高(P<0.05)。术后24 h观察组血清NE、E、Ang-Ⅱ、Cor水平较对照组低(P<0.05)。观察组并发症发生率较对照组低(P<0.05);2组患者子宫切除率比较差异无统计学意义(P>0.05)。结论可吸收止血微球应用于前置胎盘剖宫产术中效果显著,可有效减少术中及术后出血量,缩短出血时间,改善凝血功能,减轻术后应激,降低并发症发生率。
Objective To explore the application effect of absorbable hemostatic microspheres in cesarean section for placenta previa.Methods A total of 80 pregnant women with placenta previa who underwent cesarean section in Hainan Women and Children Medical Center from January 2018 to March 2021 were collected.According to different treatment methods,they were divided into the observation group and the control group,with 40 cases in each group.The control group was treated with routine preventive hemostasis measures,and the observation group was treated with absorbable hemostatic microspheres in addition to the control group.The blood loss during operation and 24 hours after operation,bleeding time,complication rate and hysterectomy rate were compared between the two groups.The coagulation functions[fibrinogen(FIB),prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)]and stress indicators[norepinephrine(NE),epinephrine(E),cortisol(Cor),and angiotensin Ⅱ(Ang-Ⅱ)]before operation and 24 hours after operation were compared between the two groups.Results The blood loss during operation and 24 hours after operation in the observation group were lower than those in the control group(P<0.05),and the bleeding time was shorter than that in the control group(P<0.05).The levels of APTT,PT,and TT 24 hours after operation in the observation group were lower than those in the control group(P<0.05),while the FIB level was higher than that in the control group(P<0.05).The levels of serum NE,E,Ang-Ⅱ and Cor 24 hours after operation in the observation group were lower than those in the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the hysterectomy rate between the two groups(P>0.05).Conclusion Absorbable hemostatic microspheres have a significant effect in cesarean section for patients with placenta previa,which can effectively reduce intraoperative and postoperative blood loss,shorten bleeding time,improve coagulation function,reduce postoperative stress,and reduce the complication rate.
作者
陈招莉
孙立莉
黄燕
张婷
李慧
李波
CHEN Zhao-li;SUN Li-li;HUANG Yan;ZHANG Ting;LI Hui;LI Bo(Department of Obstetrics and Gynecology,Hainan Women and Children Medical Center,Haikou Hainan 570000,China;Department of Obstetrics and Gynecology,First Affiliated Hospital of Hainan Medical College,Haikou Hainan 570100,China)
出处
《局解手术学杂志》
2023年第6期536-539,共4页
Journal of Regional Anatomy and Operative Surgery
基金
海南省卫生计生行业科研项目(20A200035)。
关键词
可吸收止血微球
前置胎盘
剖宫产
凝血功能
应激反应
absorbable hemostatic microspheres
placenta previa
cesarean section
coagulation function
stress response
