高危孕产妇剖宫产术中不同时间应用卡前列素氨丁三醇对其出血量的影响

Effects of Romethamine on the Amount of Bleeding in Cesarean Section at Different Time Points of High Risk Parturients

目的:观察高危妊娠孕产妇剖宫产术中不同时间应用卡前列素氨丁三醇对其出血量的影响。方法:收集180例有产后出血倾向并行剖宫产术的高危孕产妇的临床资料进行回顾性分析,依据卡前列素氨丁三醇的使用时间分为研究组和对照组。研究组产妇在胎儿娩出后即宫体注射卡前列素氨丁三醇250μg,并静脉滴注缩宫素10 u;对照组产妇在胎儿娩出后先后宫体注射和静脉滴注缩宫素10 u,若宫缩乏力致出血量增加且按摩子宫无效时再行宫体注射卡前列素氨丁三醇250μg。两组孕产妇均可视情况继续使用卡前列素氨丁三醇。比较两组产妇的出血量和不良反应发生情况。结果:研究组产妇产后出血的发生率为17.7%,显著低于对照组(28.7%),且研究组产妇产后2 h和24 h的出血量均显著少于对照组,两组比较差异均有统计学意义(P<0.05)。两组孕产妇不良反应均较轻微,可自行好转。结论:对有产后出血倾向的高危孕产妇在胎儿娩出后立即应用卡前列素氨丁三醇可有效减少产后出血的发生,且安全性较好。

OBJECTIVE： To observe the effects of romethamine on the amount of bleeding in cesarean section of high risk parturients at different time points. METHODS： The clinical data of 180 high risk parturients with postpartum hemorrhage tendency in cesarean section retrospectively analyzed and divided into treatment group and control group according to the duration of romethamine treatment. Treatment group was given intrauterine injection of romethamine 250 μg and intravenous dripping of oxytocin 10 u after the delivery of fetus; control group was given intrauterine injection of romethamine 250 pg if the amount of bleeding increased due to uterine inertia and uterine massage was invalid, following intrauterine injection of oxytocin 10 u intravenously after the delivery of fetus. Both groups were given romethamine continuously, depending on the situation. The amounts of bleeding and adverse drug reactions were recorded in 2 groups. RESULTS： The incidence of postpartum hemorrhage in treatment group was 17.7%, which was significantly lower than in control group （28.7%）; the amount of bleeding in treatment group 2 h and 24 h after operation were significantly lower than in control group; there was statistical significance （P〈0.05）. Adverse drug reaction of 2 groups was slight and recovered spontaneously. CONCLUSIONS： The application of romethamine in advance could effectively decrease postpartum hemorrhage in high risk parturients with postpartum hemorrhage tendency, and it＇ s safety.