1 海口市妇幼保健院妇产科，海口 570102
|| 2015 年度海南省卫生与计划生育行业科研项目 (15A200037)。
目的：探讨剖宫产术后母子早接触、婴儿早吸吮母乳结合子宫阴道纱布填塞在治疗产后出血的作用。方法：选择2016年2月至2017年6月选择在海口市妇幼保健院门诊部建卡并进行剖宫产的产后出血产妇108例作为研究对象，根据治疗方法的不同分为实验组(68例)与对照组(40例)，对照组给予子宫阴道纱布填塞治疗，实验组在对照组治疗的基础上让母子早接触、婴儿早吸吮母乳，记录两组治疗效果与预后情况。结果：实验组与对照组的纱布填塞时间分别为(16.87±3.19) h和(19.92±3.45) h，实验组显著少于对照组(P<0.05)；实验组与对照组的治疗有效率分别为97.1%和85.0%，实验组显著高于对照组(P<0.05)。实验组的子宫动脉结扎率、子宫切除率分别为2.9%和0.0%，对照组分别为12.5%和2.5%，两组对比差异无统计学意义(P>0.05)。实验组产后14 d的贫血、切口愈合不良、感染、下肢静脉炎等并发症发生率为4.4%，对照组为40.0%，实验组显著低于对照组(P<0.05)。结论：剖宫产术后母子早接触、婴儿早吸吮母乳结合子宫阴道纱布填塞对治疗产后出血可提高治疗效果，降低子宫动脉结扎率、子宫切除率，减少产后并发症发生，有很好的应用可行性。
Effect of mother’s early touch and newborn infant’s early sucking combined with vaginal gauze tamponade on the treatment of postpartum hemorrhage after cesarean section
CorrespondingAuthor: FANG Jinhua
This work was supported by the Research Projects of Health Family Planning Industry in Hainan Province in 2015, China (15A200037).
Objective: To explore the feasibility of early contact between mother and child and early sucking and vaginal gauze tamponade in the treatment of postpartum hemorrhage after cesarean section. Methods: From February 2016 to June 2017, 108 patients with postpartum hemorrhage after cesarean section in the district in outpatient department of our hospital were enrolled and were divided into an experimental group of 68 patients and a control group of 40 patients according to the different treatment methods. The patients in the control group were given vaginal gauze tamponade treatment, the experimental group were given early contact and early sucking treatment based on the treatment of control group, two groups of therapeutic effect and prognosis were observed. Results: The vaginal gauze tamponade time in the experimental group and the control group was (16.87±3.19) h and (19.92±3.45) h, respectively, which the former group was significantly shorter than latter (P<0.05). The effective rates of the experimental group and the control group were 97.1% and 85%, respectively, and the effective rate in the experimental group was also significantly higher than that in the control group (P<0.05). The ligation rate and hysterectomy rate of the experimental group were 2.9% and 0%, respectively, and those of the control group were 12.5% and 2.5%, respectively. There were no significant between the two groups (P>0.05). The incidence of complications such as anemia, wound healing, infection and phlebitis of the lower limbs in the experimental group were 4.4%, which in the control group were 40%, and There were significantly differences between the two groups (P<0.05). Conclusion: The early contact and early sucking and vaginal gauze tamponade in the treatment of postpartum hemorrhage after cesarean section can improve postpartum hemorrhage, reduce uterine artery ligation rate, hysterectomy rate and reduce postpartum complications. It has a good application feasibility.
cesarean section; contact between mother and child; breast sucking; vaginal gauze tamponade; postpartum hemorrhage