卡前列素氨丁三醇在高危孕产妇剖宫产中应用时机研究

Research on Application Time and Efficacy of Carboprost Trometamol for High Risk Parturients in Cesarean Section

目的:探讨卡前列素氨丁三醇在剖宫产术中出血的应用时机选择及疗效观察。方法:对90例高危实施剖宫产的孕产妇临床资料进行回顾性分析,按卡前列素氨丁三醇的使用时间分为预防组和对照组,其中预防组患者在胎儿娩出后即宫体注射卡前列素氨丁三醇250μg并静脉滴注20 U缩宫素;对照组在胎儿娩出后宫体注射并静脉滴注缩宫素20 U后,如宫缩乏力致出血量超过400 mL且按摩子宫无效再行宫体注射卡前列素氨丁三醇250μg。比较2组患者的术中、术后出血量及不良反应发生情况。结果:预防组产后出血发生率为17.8%低于对照组的28.9%,差异有统计学意义(P<0.05)。预防组产后2 h和24 h出血量均少于对照组,差异均有统计学意义(P<0.05)。结论:对有产后出血倾向的高危孕产妇预防性应用卡前列素氨丁三醇可有效减少产后出血的发生。

Objective To explore the application time and clinical efficacy of carboprost trometamol for high risk parturients in cesarean section.Methods The clinical data of 90 high risk parturients were retrospectively analyzed and divided into prevention group and control group based on the application time of carboprost trometamol.In prevention group,carboprost trometamol were injeceted into uterus with dose of 250 μg and oxytocin were intravenous dripped with dose of 20 U in 45 cases.In control group,oxytocin were intravenous dripped and injeceted into uterus with dose of 20 U,respectively,then when the bleeding volume were over 400 mL caused by uterine inertia and massage were invalid,carboprost trometamol were given by injeceting into uterus with dose of 250 μg.The bleeding volume during operation and post operation were compared and the side effects were recorded in two groups.Results The bleeding rate of prevention group was 17.8%,which was significantly higher than that of control group(28.9%)(P<0.05).The bleeding volume of prevention group in 2 h and 24 h post operation were significantly lower than those of control group(P<0.05).Conclusion The preventive application of carboprost trometamol could effectively decrease the bleeding rate for high risk parturients in cesarean section.