卡前列素氨丁三醇在不同高危因素剖宫产术中预防产后出血的效果观察

The effects of romethamine on preventing postpartum hemorrhage of different high risk factors cesarean section

目的:观察卡前列素氨丁三醇在不同高危因素剖宫产术中预防产后出血的效果。方法:随机抽取有双胎、羊水过多、巨大儿高危因素的剖宫产产妇作为研究组Ⅰ和对照组Ⅰ,各300例;另外随机抽取孕41周经过3 d缩宫素引产失败的剖宫产产妇作为研究组Ⅱ和对照组Ⅱ,各100例。研究组在胎儿娩出后立即子宫注射卡前列素氨丁三醇250μg,以后根据子宫收缩情况再决定第二次用药,手术结束后直肠给卡前列甲酯栓0.5 mg,间隔50 min再次给药。对照组均在胎儿娩出后常规缩宫素10 U子宫肌内直接注射,如果出血多、子宫收缩不佳,再直接注射卡前列素氨丁三醇250μg于子宫。结果:研究组胎儿娩出后和术后2 h及24 h失血量均明显少于对照组(P<0.01)。结论:对有产后出血高危因素的产妇,剖宫产术中第一时间应用卡前列素氨丁三醇,可减少胎儿娩出后及术后24 h出血量,对产后出血及切除子宫具有一定的临床意义。

Objective：To observe the effects of romethamine on preventing postpartum hemorrhage of different high risks cesarean section. Methods：Six hundred puerperas with bigeminal,hydramnios and giant infant were divided into the treatment group Ⅰ and the control group Ⅰ（300 cases per group）,and 200 puerperas with oxytocin induction failure using oxytocin for 3 days of in the 41st week pregnancy were divided into the treatment group Ⅱ and the control group Ⅱ（100 cases per group）.Romethamine 250 μg were immediately injected into the uterus of the treatment group Ⅱ after delivery,which were reused according to the uterine contraction,and 0.5 mg carboprost methylate at the 50 min interval were given through rectum after operation.Oxytocin 10 U were injected into myometritis of all control groups,romethamine 250 μg were injected into the uterus if much bleeding or bad uterine contraction were found. Results：The intraoperatie bleeding and the total amount of bleeding were significantly less than that of control groups（P0.01）. Conclusions：The romethamine must be used at first time in high-risk mothers cesarean section,which can decrease the bleeding of preoperative and postoperative and have a certain clinical significance to avoid or eliminate the bleeding after delivery and hysterectomy.