卡前列素氨丁三醇及卡前列酸栓与缩宫素联用预防高危剖宫产产妇产后出血的对比研究

A comparative study of carboprost tromethamine and carboprost suppositories combined with oxytocin on postpartum hemorrhage in high-risk puerperas with caesarean section

目的对比观察卡前列素氨丁三醇及卡前列酸栓与缩宫素联用预防高危剖宫产产妇产后出血的疗效。方法回顾性分析2015年1月至2017年8月在廊坊市第四人民医院有产后出血倾向的高危产妇195例的临床资料,根据用药不同分为A组、B组及对照组,每组65例。3组剖宫产术后立即行子宫按摩,同时静脉滴注缩宫素10 IU。在此基础上A组阴道给药卡前列酸栓1 mg; B组宫体注射卡前列素氨丁三醇250μg;对照组宫体注射缩宫素10 IU。比较3组术中出血量、产后2 h内出血量、产后2 h～24 h出血量、产后24 h血红蛋白下降值、产后出血率、输血率、其他止血措施使用率、用药后不良反应发生率。结果 (1) A组和B组术中出血量、产后2 h内出血量、产后2 h～24 h出血量及产后24 h血红蛋白下降值低于对照组,B组以上指标低于A组,差异均有统计学意义(P <0. 05)。(2)与对照组比较,A组和B组产妇产后出血率、输血率下降,差异均有统计学意义(P <0. 05)。(3) 3组产妇用药后均有恶心呕吐、腹泻、高血压、体温升高等轻度不良反应,但发生率比较,差异无统计学意义(P>0. 05)。结论卡前列素氨丁三醇及卡前列酸栓与缩宫素联用可明显减少高危产妇出血量和输血率,卡前列素氨丁三醇与缩宫素联用效果更为显著。

Objective Contrast observation of the efficacy of carboprost tromethamine and carboprost suppositories combined with oxytocin on postpartum hemorrhage in high-risk puerperas with caesarean section. Methods 195 cases of high-risk puerperas with caesarean section were divided into control group( n = 65),group A( n = 65) and group B( n = 65) according to different medications. All puerperas were implemented uterine massage after childbirth,and intravenous injection of oxytocin 10 IU. In addition,the puerperas were injected oxytocin 10 IU in control group,sublingual carboprost suppositories 1 mg in group A,intrauterine injection of carboprost tromethamine 250 μg in group B. Intraoperative blood loss,postpartum hemorrhage amount within 2 h,postpartum 2 h to 24 h blood loss,postpartum 24 h hemoglobin decreased value,rate of postpartum hemorrhage,blood transfusion rate,other hemostatic measures utilization rate,incidence of adverse reactions after the medication were compared in three groups.Results(1) Intraoperative blood loss,postpartum hemorrhage amount within 2 h,postpartum 2 h to 24 h blood loss,postpartum 24 h hemoglobin decreased value in group A and group B were lower significantly than those in control group,the above indicators in group B were significantly lower than those in group A,the differences were statistically significant( P < 0. 05).(2) Compared with those in control group,the rate of postpartum hemorrhage,the blood transfusion rate decreased significantly,the differences were statistically significant( P < 0. 05).(3) Mild adverse reactions such as nausea and vomiting,diarrhea,high blood pressure,elevated body temperature happened in three groups,there were no statistical differences( P < 0. 05). Conclusion Carboprost tromethamine and carboprost suppositories combined with oxytocin can reduce significantly blood loss and blood transfusion rates in high-risk puerperas,the effects of carboprost tromethamine combined with oxytocin were more significant.