卡前列素氨丁三醇治疗宫缩乏力性产后出血的效果观察

Effect observation of carboprost tromethamine in the treatment of postpartum hemorrhage due to uterine inertia

目的 探讨卡前列素氨丁三醇治疗宫缩乏力性产后出血的临床效果。方法 选择本院2010年1月~2013年12月收治入院的宫缩乏力致产后出血的产妇200例,随机分为对照组100例和观察组100例,对照组采用米索前列醇直肠给药0.4 mg＋静脉滴注缩宫素20 U,同时按摩子宫,观察组在对照组基础上采用卡前列素氨丁三醇治疗,记录并比较两组产妇产后出血量、第三产程时间、产后出血发生率、总有效率及不良反应发生率。结果 观察组产后2、24 h出血量明显少于对照组,差异有统计学意义（P〈0.01）。观察组第三产程时间短于对照组,差异有统计学意义（P〈0.05）。观察组产后出血发生率为12.0%,低于对照组的25.0%,差异有统计学意义（P〈0.01）。观察组总有效率为94.0%,高于对照组的81.0%,差异有统计学意义（P〈0.05）。观察组发生颜面潮红、恶心、呕吐、腹泻、寒战和血压上升等不良反应10例,对照组出现不良反应2例,两组的不良反应发生率比较差异无统计学意义（P〉0.05）。结论 卡前列素氨丁三醇治疗宫缩乏力性产后出血的效果明显,且具有方便、快速、高效和安全的特点,但应明确诊断,及时使用。

Objective To explore the clinical effect of carboprost tromethamine in the treatment of postpartum hemorrhage due to uterine inertia. Methods 200 puerperae who suffered from postpartum hemorrhage due to uterine inertia admitted into our hospital from January 2010 to December 2013 were selected and evenly divided into control group and observation group in random.In the control group,rectal administration of 0.4 mg misoprostol,20 U oxytocin for intravenous drip and simultaneous massage of the uterus were applied.In the observation group,on the basis of the control group,hemabate was added.The amount of bleeding after delivery,the third labor time,incidence rate of postpartum hem orrhage,total effective rate and incidence rate of adverse reaction in two groups was recorded and compared respectively. Results Amount of bleeding after delivery of 2,24-hour in observation group was greatly less than that in control group respectively,with statistical difference （P〈0.01）.The third labor time in observation group was shorter than that in control group,with statistical difference （P〈0.01）.The incidence rate of postpartum hemorrhage in observation group was 12.0%,lower than that in control group（25.0%）,with a statistical differenee（P〈0.01）.The total effective rate in observation group was 94.0%,higher than that in control group（81.0%）,with statistical difference（P〈0.05）.10 cases occurred with ad- verse reactions including facial blushing,nansea,vomiting,abdominal diarrhea,shiver and blood pressure increasing in observation group,only 2 cases occurred with adverse reactions in control group.The incidence rate of adverse reaction in two groups was compared,with no statistical difference （P〉0.05）. Conclusion Carboprost tromethamine in the treatment of postpartum hemorrhage due to uterine inertia can obtain a great effect,has advantages of convenience,fast,efficiency and safety.However,hemabate should be used in time after making a definite diagnosis.