卡前列甲酯减少产后出血的临床研究

Clinical study on reduction of postpartum bleeding by methyl carprost suppository

【目的】探讨卡前列甲酯减少产后出血量的效果和安全性。【方法】选择300例正常足月妊娠阴道分娩者,随机分为研究组和对照组。研究组150例,在胎儿娩出后直肠放置卡前列甲酯1mg+臀部肌肉注射催产素20IU;对照组150例,在胎儿娩出后只是臀部肌肉注射催产素20 IU,分别观察第三产程时间、术后2 h及24 h的出血量(ml)及使用卡前列甲酯前、后2 h心率、血压变化。【结果】第三产程:研究组(7.55±3.06)min,对照组(12.54±3.28)min,差异有显著性(P<0.01);出血量:研究组(148.20±32.54)ml和(200.35±45.70)ml,对照组(210.10±51.05)ml和(287.65±54.80)ml,差异有显著性P<0.01;使用卡前列甲酯前及使用后2 h心率、血压变化的比较,均为P>0.05,差异无显著性。【结论】直肠放置卡前列甲酯可缩短第三产程、减少出血量,方便、安全、快速、有效。

[ Objective] To observe the effects and safety of methyl carprost suppository on reduction of postpartum bleeding in normal paturients. [Methods] Three hundreds normal parturients were randomly divided into study group （ n = 150） and contral group randomly （ n = 150）. Parturients in study group were administered methyl carprost suppository via rectum and given 20IU oxytocin intramuscnlai injection in buttocks immediately. The controls were only given 20IU oxytocin. To observe the period of the third stage of mnltiusim, the amounts of bleeding within 2 hours and 24 hours postpartum and variation the rhythm of heart and blood pressure before and after using drug, [ Results] The third stage of the mnltiusim , study group was shorter than contral group There was siginificant difference in period of the third stage of multiusim between study group and control group. （ P 〈 O. 01 ）. The amounts of bleeding of study group was （ 128.20± 32.54 ） ml and （210.10 ± 31.05） ml respectively . In contrast, the amount of bleeding for contral group was （200.35 ± 45.70） ml and （287.65± 44.80） ml respectively. There was significant difference in the amounts of bleeding between study group and control group （ P 〈 0.01）. Whereas the differences of rhythm of heart and blood pressure before using methyl earprest suppository and after using it in 2 hours were not significant （P 〉 0.05）. [ Conclusions] Via rectum Methlyl carprost suppository can shorten the third stage of the mnltiusim and reduce postpartum bleeding. This method is simple, safe, quickly and effective.