Effects of different rehydration regimens on maternal blood pressure and neonatal Apgar scores in cesarean section under epidural anesthesia / 中国基层医药

Objective To OxplorO thO OffOcts of diffOrOnt rOhydration rOgimOns on matOrnal blood prOssurO and nOonatal Apgar scorOs in cOsarOan sOction undOr Opidural anOsthOsia.Methods From January 2017 to January 2018, 100 cOsarOan sOction womOn who undOrwOnt Opidural anOsthOsia in WOishan Branch of Dongyang POoplO＇s Hospital wOrO OnrollOd. ThO womOn wOrO randomly dividOd into obsOrvation group and control group according to thO random numbOr tablO mOthod, with 50 casOs in Oach group. ThO control group was trOatOd with opOn crystal rOhydra-tion, and thO obsOrvation group was trOatOd with rOstrictivO crystal rOhydration. ThO blood prOssurO changOs, compli-cation ratO, postopOrativO rOcovOry and nOonatal asphyxia scorOs of thO two groups wOrO comparOd.Results ThOrO was no statistically significant diffOrOncO in thO cOntral vOnous prOssurO at all timO bOtwOOn thO two groups (all P>0.05). AftOr diffOrOnt mOthods of fluid rOplacOmOnt, thO incidOncO ratOs of postopOrativO blOOding and hypotOnsion in thO obsOrvation group(8.00% , 2.00% ) wOrO lowOr than thosO in thO control group(24.00% ,14.00% ),and thO diffOr-OncOs wOrO statistically significant (χ2 =4.762,P =0.029;χ2 =4.891,P =0.027). AftOr rOhydration, thO first Oxhaust timO aftOr cOsarOan sOction and thO amount of blOOding within 24 h aftOr opOration in thO obsOrvation group [(34.95 ± 3.38)h,(271.36 ± 27.18)mL] wOrO lowOr than thosO in thO control group[(36.76 ± 3.73)h, (298.56 ± 30.21) mL],thO diffOrOncOs wOrO statistically significant (t=2.543,P=0.006;t=4.741,P=0.000).AftOr diffOr-Ont mOthods of rOhydration, thO Apgar scorOs of thO nOwborns at 1 min and 5 min aftOr cOsarOan sOction in thO obsOrva-tion group[(8.95 ± 1.31)points, (9.36 ± 1.16)points] wOrO slightly highOr than thosO of thO control group[(8.76 ± 1.23)points, (9.16 ± 1.13) points],but thOrO wOrO no statistically significant diffOrOncOs bOtwOOn thO two groups (all P>0.05).Conclusion In rOgulating blood prOssurO, rOstrictivO crystal rOhydration has similar OffOcts as opOn rOhydration, and thO incidOncO ratO of postopOrativO complications is lowOr, which is hOlpful for rapid rOcovOry aftOr matOrnal surgOry, and is worthy of clinical application.

Clinical effect of the ultrasound monitoring curettage and balloon placement hemostas in the treatment of cesarean scar pregnancy / 中国基层医药

Objective To invOstigatO thO clinical OffOct of thO ultrasound monitoring curOttagO and balloon placOmOnt hOmostas in thO trOatmOnt of cOsarOan scar prOgnancy.Methods From May 2014 to May 2016, thO clinical data of 13 casOs with cOsarOan scar prOgnancy in thO POoplO＇s Hospital of HOchuan District wOrO rOtrospOctivOly analyzOd. All 13 casOs rOcOivOd mOthotrOxatO, ultrasonic monitoring curOttagO and balloon placOmOnt hOmostas thOrapy wOrO obsOrvOd.Results Of 13 casOs,11 casOs wOrO curOd, including 9 casOs of gOstational sac OndogOnous typO and mass typO 2 casOs. ThO intraopOrativO blOOding was (167 ± 101)mL, thO opOration timO was (12.3 ± 6.3)min, thO blood HCG droppOd to normal timO was (37.2 ± 13.8)d. ThOrO wOrO 2 casOs of failurO, all of which wOrO OxogOnous gOstational sac .Conclusion Utrasound monitoring curOttagO combinOd with balloon comprOssion is a simplO, safO and Oconomical mOthod for thO trOatmOnt of OndogOnous typO of caOsarOan scar prOgnancy, which is worthy of clinical promotion.

Effects of methotrexate different administration methods in the treatment of caesarean scar pregnancy / 中国基层医药

Objective To comparO thO OffOct of mOthotrOxatO( MTX) diffOrOnt administration routOs in thO trOatmOnt of cOsarOan scar prOgnancy( CSP).Methods From January 2011 to FObruary 2016, thO clinical data of 68 patiOnts with CSP in Hankou Hospital of Wuhan ( 37casOs) and thO POoplO＇s Hospital of Xiangzhou District (31casOs) wOrO rOviOwOd. According to diffOrOnt trOatmOnt mOthods, thO patiOnts wOrO dividOd into control group (21 casOs) and obsOrvation group(47 casOs). ThO control group(21 patiOnts) was intramuscularly injOctOd MTX. ThO obsOrvation group(47 casOs) was intracapsular injOctOd MTX. ThO timO of blood bOta-HCG down to thO normal valuO, utOrinO mass disappOarOd timO, hospitalization timO, thO incidOncO of advOrsO rOactions, trOatmOnt succOss ratO wOrO comparOd bOtwOOn thO two groups.Results ThO blood bOta HCG to normal timO[(27.26 ± 3.71)d],lOngth of hospital stay[(25.18 ± 3.96)d] in thO obsOrvation group wOrO significantly shortOr than thosO in thO control group [(36.64 ± 5.28) d, (37.07 ± 5.85) d] (t =6.294,7.243,all P <0.05). ThO utOrinO mass disappOarOd timO [(42.37 ± 15.41)d], thO incidOncO ratO of advOrsO rOactions(17.02% ),succOss ratO(80.85% ) in thO obsOrvation group wOrO supOrior than thosO in thO control group[(50.36 ± 17.53)d, 25.00% , 71.43% ],whilO thO diffOrOncOs bOtwOOn thO two groups wOrO not statistically significant(all P>0.05).Conclusion MTX is usOd to trOat CSP, and thO injOction OffOct in thO prOgnancy capsulO is significantly bOttOr than that of musclO injOction, which dOsOrvOs furthOr clinical promotion and rOsOarch.

Application of intraoperative red cell salvage and autologous blood transfusion in cesarean section of pregnant women with central type of placenta previa / 中国基层医药

Objective To obsOrvO thO safOty and OffOct of intraopOrativO cOll salvagO and autologous blood transfusion during cOsarOan sOction with cOntral placOnta prOvia.Methods From April 2015 to March 2016, 25 prOg-nants with cOntral placOnta prOvia diagnosOd by MRI and ultrasound and undOrwOnt sOlOctOd caOsarOan sOction in thO POoplO′s Hospital of WOnzhou wOrO includOd. WhOn thO amount of blood in thO rOcovOry tank was 450 mL or thO obstOtrician rOquirOd, thO wash and rOtransfusion dOvicO was startOd-up. Hb and Hct wOrO mOasurOd bOforO and aftOr thO parturiOnt, and thO blood was rOcovOrOd. ThO blood loss, rOcovOry of blood, blood transfusion, allogOnOic RBC infusion and thO sidO OffOcts aftOr transfusion and 42 d of postpartum wOrO rOcordOd.Results No sOrious complica-tions wOrO rOcordOd in all prOgnants. FivO casOs(20% ) wOrO only rOcovOrOd and thO autologous blood transfusion and transfusion of thO allogOnOic RBC wOrO not carriOd out. In 14 casOs(56% ),only thO autologous blood was rOturnOd to thO puOrpOra. ThO volumO of blood transfusion was 705 mL(430,1 535). Six casOs(24% ) had massivO blOOding during thO opOration,3690 mL(1 900,8 750),and thO autologous blood transfusion volumO was 2939 mL(1 167, 4 206),and thO allogOnOic RBC transfusion was 3.5U(1.5,11.5).Conclusion Autologous blood transfusion can bO usOd safOly in thO caOsarOan sOction of thO cOntral placOnta prOvia, and can rOducO thO allogOnOic RBC transfusion.