卡前列素氨丁三醇注射液治疗高危产妇术后出血的疗效观察

Effect observation of postoperative hemorrhage of carboprost trometamol for high risk pregnant women

目的观察宫缩剂治疗高危产妇剖宫产术中及术后出血的效果。方法选取我科高危因素剖宫产252例产妇随机分为观察组(n=132)和对照组(n=120),观察组剖宫产术后除常规治疗外,提前给予卡前列素和缩宫素治疗;对照组患者常规治疗外仅用缩宫素。观察比较两组产妇产时及产后72 h常规凝血指标,并比较两组产妇术中、术后总出血量及第三产程时间和副反应发生率。结果与对照组相比,观察组产妇术中及术后出血量明显减少,差异有统计学意义(P<0.05);两组产妇中总出血量≥1000 mL有25例,其中对照组14例(56.0%),观察组11例(44.0%),差异有统计学意义(P<0.05);按产妇高危因素分类,巨大儿10例(40.0%),双胎9例(36.0%),前置胎盘6例(24.0%),所有产妇无子宫切除病例。副反应发生率对照组有22例(18.3%);观察组有17例(12.9%)。结论卡前列素和缩宫素联合用药可以减少高危产妇剖宫产术后出血和副反应发生率,并缩短第三产程时间,临床上值得推广和应用。

Objective To observe the effects of uterotonics on prevention of postpartum hemorrhage in cesarean section and after cesarean section in high risk pregnant women. Methods A total of 252 pregnant women in our department were randomly divided into observation group （132 cases） and control group （120 cases）. The pregnant women after ce- sarean section in observation group were received carboprost combined oxytocin besides routine therapy, and the preg- nant women in control group were only received oxytocin besides routine therapy. The conventional coagulation param- eters in intrapartum postpartum were detected and the postpartum hemorrhage, duration of third stage of labor and in- cidence of side effects in cesarean section and after cesarean section were observed and compared between two groups. Results The volume of postpartum hemorrhage in cesarean section and after cesarean section in observation group was less than that in control group, there was significant difference （P 〈 0.05）; Among 252 cases, 25 cases had total amount of bleeding more than 1000 mL during operation and within 2 h and 24 h after delivery. There were 56.0% （14 cases） in the control group and 44.0% （11 cases） in the observation group with statistical significance （P 〈 0.05）. There were 40.0% fetal macrosomia, and 36.0% twin pregnancy and 24.0% placenta previa among the pregnant women. No hysterectomy was done between the two groups. The incidence of side effects between the two groups was 18.3%, 12.9%. Conclusion Carboprost combined oxytocin can reduce the volume of postpartum hemorrhage and incidence of side effects in cesarean section and after cesarean section in high risk pregnant women, and shorten duration of third stage of labor. It is worthy to be promoted and applied in clinic.