卡前列素氨丁三醇治疗严重产后出血47例

Carboprost tromethamine in treating severe postpartum hemorrhage of 47 patients

目的：回顾性观察卡前列素氨丁三醇在治疗严重产后出血中的疗效。方法：在我科住院分娩使用卡前列素氨丁三醇治疗严重产后出血47例病人,经徒手按摩子宫,追加缩宫素20 IU静脉注射或联合米索前列醇200～400μg嚼碎舌下含服后子宫收缩仍然不良时,肌内注射或宫体注射卡前列素氨丁三醇。重复使用时,间隔时间大于15 min。结果：卡前列素氨丁三醇注射后子宫变硬,出血减少,注射1针(250μg)总体成功率为86%,96%的病人用量250～500μg。不良反应是胃肠道反应,恶心呕吐发生率为30%,腹泻发生率为13%。结论：卡前列素氨丁三醇治疗严重产后出血,疗效迅速且不良反应少,给药方便。

AIM ：To review the therapeutic effects of carboprost tromethamine on severe postpartum hemorrhage. METHODS ： In the department of gynecology and obstetrics of the Second Affiliated Hospital of Wenzhou Medical College, 47 patients with severe postpartum hemorrhage because of uterine inertia were conducted under an injection of carboprost tromethamine intramuscularly or intranuterinely. Beforehand, there was no evident response to the conventional therapies including massaging the uterus and administrating additional oxytocin 20 IU intravenously or combination of misoprostol 200 - 400 μg sublingually. The time interval for splitting multiple doses should be more than 15 minutes. RESULTS：Uterus retracted quickly and bleeding decreased obviously after the injection of carboprost tromethamine. The effective rate after one injection（250 μg） was 86 % and effective ness to all the patients who were achieved after three injections. The dosage for 96 % patients was 250 - 500 μg, with common adverse reactions of gastrointestinal tract including nausea and vomiting （30 %） and diarrhea （13 %）. CONCLUSION： Carboprost tromethamine possessed remarkable effect on severe postpartum hemorrhage, with easy administration, quick response and few adverse reactions.