卡前列素氨丁三醇预防瘢痕子宫剖宫产产后出血的价值

目的 探讨卡前列素氨丁三醇预防瘢痕子宫剖宫产产后出血的价值.方法 选择2016年1月至2017年12月行剖宫产瘢痕子宫的产妇166例,将所有产妇随机分为观察组与对照组,各83例,娩出胎儿胎盘后,对照组产妇给予缩宫素,观察组产妇给予缩宫素联合卡前列素氨丁三醇.比较两组产妇产中及产后2h、24h的出血量,产前及产后的血红蛋白水平,记录产妇产后出血发生率、输血率及止血时间,并观察记录产妇不良反应发生情况.结果 观察组产妇产中、产后2h、产后24h的出血量均显著低于对照组产妇,同时观察组产妇的止血时间明显短于对照组产妇,差异均有统计学意义(P<0.05);观察组产妇产后出血率、输血率均明显低于对照组产妇,而观察组产妇产后血红蛋白水平显著高于对照组,差异均有统计学意义(P<0.05);两组产妇均有不同程度的不良反应发生,观察组产妇不良反应发生率显著低于对照组,差异有统计学意义(P<0.05).结论 卡前列素氨丁三醇预防瘢痕子宫产妇剖宫产产后出血效果显著,能有效降低产妇产后出血发生率及出血量,缩短出血时间,且安全可靠,减少不良反应发生率,值得临床推广.

Objective To investigate the clinical effect of carboprost tromethamine in the prevention of postpartum hemorrhage in scar uterus. Methods From January 2016 to December 2017,166 cases of cesarean scar pregnancy were performed in obstetrics department of our hospital,all the maternal were randomly divided into the observation group and the control group on average. In the control group,the uterus was injected with oxytocin,and the observation group was given oxytocin combined with carboprost tromethamine. The amount of bleeding at 2h intraoperative and postoperative and 24h postoperative. The preoperative and postoperative hemoglobin levels of two groups were compared. The incidence of postpartum hemorrhage,the rate of blood transfusion and the time of hemostasis,and the occurrence of adverse reactions were recorded. Results In the observation group,the amount of bleeding in the intraoperative,postpartum,2h and 24h postpartum was significantly lower than that in the control group,at the same time,the bleeding time of observation group was significantly shorter than that of the control group,the differences were statistically significant (P<0.05);the observation group of postpartum hemorrhage,blood transfusion rate was significantly lower than the control group,the observation group of postpartum hemoglobin level was significantly higher than the control group,the difference was statistically significant(P<0.05);the two groups had different degrees of adverse reactions,and the incidence of adverse reactions in the two groups was significantly lower than that in the control group,and the difference was statistically significant(P<0.05). Conclusion Carboprost tromethamine can prevent postpartum hemorrhage of scar uterus parturients after cesarean section. It can effectively reduce the incidence and amount of postpartum hemorrhage,shorten the bleeding time,and is safe and reliable,and reduce the incidence of adverse reactions,it is worthy of clinical promotion.