卡贝缩宫素与卡前列素氨丁三醇预防产后出血作用的比较

Comparison of the Effectiveness of Carbetocin and Hemabate for the Prevention of Postpartum Hemorrhage

目的:比较卡贝缩宫素和卡前列素氨丁三醇预防产后出血的疗效与安全性。方法:对312例至少含有1项发生产后出血(PPH)危险因素的产妇进行随机对照研究。卡贝缩宫素组168例产妇在胎儿娩出后立即静脉注射100μg卡贝缩宫素,卡前列素氨丁三醇组144例产妇胎儿娩出后立即肌内或宫体注射200μg卡前列素氨丁三醇。记录两组产妇产后24h出血量,产前和产后24h取外周血化验。观察指标分析包括产后24h内出血总量、血红蛋白下降、额外宫缩剂或子宫按摩的需要以及不良反应发生情况。结果:两组产后24h内出血总量无显著差异,两组需要额外用宫缩剂的例数无显著差异。但卡前列素氨丁三醇组不良反应例数显著多于卡贝缩宫素组。结论:与卡前列素氨丁三醇相比,卡贝缩宫素在预防产后出血方面同样有效,两者无显著差异,但卡贝缩宫素不良反应较少,产妇可接受性较强。

Objective：To investigate the efficacy and safety of carbetocin and hemabate for the prevention of postpartum hemorrhage after labor of high risk of postpartum hemorrhage patients. Methods：A total of 312 women who have at least 1 kind of high risk of PPH were randomly assigned into two groups, 168 in the cabetocin group and 144 in the hemabate group. After delivery of baby, 100 μg carbetocin were injected intravenously to women in carbetocin group, while the women in hemabate group, 200 μg hemabate were injected intramuscular or injected on the uterine body. The blood loss in 24-hour postpartum ,hemoglobin level and extra drug use of the women were compared to determine the effectiveness. Results： The mean blood loss in the 24-hour postpartum had no significant difference between the two groups. The extra drug use had no significant difference between the two groups. Conclusion： The effectiveness of earbetocin and hemabate is similar to control the postpartum hemorrhage. The carbetocin has fewer side effection and is well tolerated.