卡前列素氨丁三醇注射液联合葡萄糖酸钙预防剖宫产后出血的疗效观察

Effect Observation of Prevention on Postpartum Bleeding in Cesarean Section by Carboprost Tromethamine Injection Combined with Calcium Gluconate

目的 探讨卡前列素氨丁三醇注射液联合葡萄糖酸钙预防高危因素致剖宫产产后出血的临床疗效.方法 选取2010年1月至2013年1月在北京市顺义区中医医院住院的具有产后出血高危因素、且明确剖宫产指征的产妇192例,将其按用药方法不同以随机数字表法分为缩宫素组和联合治疗组各96例,在胎儿娩出后,缩宫素组给予缩宫素10～20 U及卡前列甲酯栓10 mg,联合治疗组在此基础上联用卡前列素氨丁三醇注射液25 μg.观察两组患者剖宫产术中及术后24 h内出血量与不良反应情况.结果 联合治疗组患者剖宫产术中及术后24 h内出血量显著少于缩宫素组[（216.9±54.4） mL vd 360.6±52.8） mL,（128.0±29.1） mL vs（221.9±42.7） mL]（P＜0.05）.且联合治疗组患者不良反应发生率显著低于缩宫素纽10.4％（10/96） vs 31.3％（30/96）]（P＜0.05）.结论 卡前列素氨丁三醇注射液与葡萄糖酸钙联合作用协同可有效预防和控制具有产后出血高危因素的剖宫产术中及术后出血,减少不良反应,值得在临床推广和使用.

Objective To investigate the preventive effect on postpartum bleeding in Cesarean section by carboprost tromethamine injection combined with calcium gluconate.Methods A total of 192 maternal patients cases with the risk factms of postpartum hemorrhage and a clear indication of Cesarean section from Jan.2010 to Jan.2013 in Traditional Chinese Medicine llospital of Beijing Shunyi District were randomly divided into oxytocin group and combination therapy group with 96 cases in each：the oxytocin group was given oxytocin 10-20 U and carboprost 10 mg,on the basic of which,the other group was added carboprost tromethamine injection 25 μg.The amount of bleeding within 24 hours and adverse reactions were observed in the two groups.Results The postoperative hemorrhage during operation and within 24 horrs after operation of the combination therapy group were significantly less than oxytocin group[（216.9 ± 54.4）mL vs（360.6 ± 52.8） mL,（128.0 ± 29.1）mL vs（221.9 ± 42.7） mL,P 〈 0.05].And adverse reactions in the combination therapy group were significantly less than the oxytocin group[10.4%（10/96） vs 31.3%（30/96）,P 〈 0.05].Conclusion Carboprost tromethamine injection combined with calcium gluconate can effectively prevent intraoperative postpartum hemorrhage of Cesarean section,reduce advmse reaction,thus is worth of promotion in clinical.