卡前列素氨丁三醇与卡前列甲酯在预防瘢痕子宫阴道分娩产后出血中的效果比较

Curative effect comparison of romethamine and carboprost methylate in prevention of postpartum hemorrhage of scar uterus vaginal delivery

目的：探讨卡前列素氨丁三醇与卡前列甲酯在预防瘢痕子宫阴道分娩产后出血中的效果对比。方法选择本院2013年1月~2014年12月收治的瘢痕子宫阴道分娩产妇120例，随机分为观察组和对照组，各60例。对照组产妇于胎儿娩出后肌内注射缩宫素20 U，同时给予卡前列甲酯1 mg舌下含服；观察组于胎儿娩出后肌内注射缩宫素20 U和卡前列素氨丁三醇250μg，对比两组产后2、24 h出血量及第三产程、产后出血发生率、不良反应发生率。结果观察组产后2、24 h出血量为（223.62±92.40）、（322.08±92.40）ml，少于对照组的（285.00±120.10）、（387.10±127.07）ml，差异有统计学意义（P〈0.05）。观察组第三产程时间为（6.87±1.60）min，短于对照组的（8.77±2.07）min，差异有统计学意义（P〈0.05）；观察组产后出血发生率（3.33%）低于对照组（13.33%），差异有统计学意义（P〈0.05）；两组不良反应发生率比较差异无统计学意义（P〉0.05）。讨论卡前列素氨丁三醇预防瘢痕子宫阴道分娩产后出血的效果优于卡前列甲酯，值得临床推广应用。

Objective To investigate the curative effect comparison of romethamine and carboprost methylate in pre-vention of postpartum hemorrhage of scar uterus vaginal delivery. Methods 120 women with scar uterus vaginal deliv-ery in our hospital from January 2013 to December 2014 were selected and randomly divided into observation group and control group,60 cases in each group.After delivery of fetus,control group were given with oxytocin intramuscular injection 20 U and carboprost methylate sublingual 1 mg at the same time,observation group were given with oxytocin intramuscular 20 U and romethamine 250μg injection.The amount of bleeding in 2,24 h after delivery,third stage of la-bor,incidence rate of postpartum hemorrhage and adverse reaction were compared between two groups of postpartum. Results In observation group,the amount of bleeding in 2,24 h after delivery was （223.62±92.40）,（322.08±92.40） ml re-spectively,less than that in control group[（285.00±120.10）,（387.10±127.07） ml] respectively,with significant difference（P〈0.05）.Third stage of labor in observation group[（6.87±1.60） min] was shorter than that in control group[（8.77±2.07） min], with significant difference（P〈0.05）.The incidence rate of postpartum hemorrhage in observation group（3.33%） was lower than that in control group （13.33%）,with significant difference （P〈0.05）.There was no statistical difference in the inci-dence rate of adverse reaction between two groups（P＆gt;0.05）. Conclusion Romethamine prevention of postpartum hemor-rhage of scar uterus vaginal delivery is better than carboprost methylate.It is worthy of clinical promotion and application.