卡前列素氨丁三醇对中央性前置胎盘剖宫产临床效果评价

Study on the application time of tromethamine in the treatment of central placenta previa cesarean section and its clinical effect analysis

目的探讨卡前列素氨丁三醇治疗中央性前置胎盘剖宫产的临床疗效和应用时机。方法入选2009年1月—2013年2月在本院进行剖宫产的中央性前置胎盘孕妇42例,随机分为预防组22例,对照组20例。对照组给予缩宫素,如宫缩较差导致出血量超过500 mL则加用卡前列素氨丁三醇子宫体注射;预防组在胎儿娩出后进行卡前列素氨丁三醇宫体注射,同时应用缩宫素。比较2组预防和减少术中出血的临床疗效和应用最佳时机,观察不良反应发生情况。结果预防组术中,术后2、24 h出血量均明显少于对照组,差异有统计学意义(P<0.05);预防组输血比例明显少于对照组,差异有统计学意义(P<0.05);2组产妇术中和术后不良反应总发生率比较无显著差异(P>0.05)。结论针对中央性前置胎盘剖宫产预防性联合应用卡前列素氨丁三醇及缩宫素较应用缩宫素后疗效不佳时应用卡前列素氨丁三醇的效果更为突出,临床安全性较高,值得临床推广应用。

Objective To investigate the application time of tromethamine in the treatment of central placenta previa cesarean section and its clinical effect analysis. Methods 42 central pla- centa previa cesarean section pregnant women from January 2009 to February 2013 in our hospital were randomly divided into prevention group with 22 patients and control group with 20 patients. The control group was given oxytocin, （if uterine bleeding over 500mL tromethamine body injection will be given） and the prevention group was conducted trometharnine intrauterine injection after the delivery of fetus. At the same time, preventing and reducing intraoperative hemorrhage of two groups and the application time were compared and the occurrence of adverse reactions was ob- served. Results The hemorrhage in the prevention group after 2 hours and 24 hours of operation were significantly less than that in the control group, the difference was statistically significant （P 〈 0.05）. Prevention group in blood transfusion rate was significantly less than that in the control group, so the difference was significant between two groups （P 〈 0.05）. The difference wasn＇t significant in two groups in the total rate of perioperative and postoperative adverse reactions （P 〉 0.05）. Conclusion The therapy of tromethamine combined with oxytocin is more prominent than the only application of tromethamine if the poor effect occurred in the operation of central placenta previa cesarean section. So it is worthy of clinical application.