卡前列素氨丁三醇注射液治疗宫缩乏力性产后出血的临床疗效分析

Analysis of clinical effect of carboprost trometamole injection in treatment hemorrhage caused by uterine inertia

目的：探讨卡前列素氨丁三醇注射液（欣母沛）治疗宫缩乏力性产后出血（PHH）的临床疗效。方法选取本院2013年1月～2014年10月接收的94例宫缩乏力性 PHH 产妇为研究对象，随机分为两组。对照组给予缩宫素、子宫按摩等常规治疗；观察组在对照组基础上给予欣母沛宫体注射，250μg/次。观察比较两组患者产后2h、产后24h 出血量。比较两组患者治疗总有效率、宫腔纱条填塞及不良反应发生率。结果产后2h，两组患者出血量比较差异无统计学意义（P ＞0.05）；给予治疗后，观察组产后24h 出血量显著低于对照组（P ＜0.05）。观察组总有效率显著高于对照组（95.7%和72.3%，x2=9.60，P=0.002），宫腔纱条填塞发生率显著低于对照组（8.51%和40.4%，x2=12.9，P=0.000），不良反应发生率高于对照组（10.6%和6.38%），但差异无统计学意义（x2=0.547，P=0.357）。结论欣母沛能够有效减少宫缩乏力性 PHH 患者的出血量，疗效确切、安全性高，值得在临床上推广应用。

Objective To investigate the curative effect of carboprost Trometamole Injection （hemabate） in treatment of postpartum hemorrhage caused by uterine inertia （PHH）. Methods 94 cases of uterine atony of maternal PHH admitted in our hospital from January 2013 to October 2014 were select as the research object and were divided into the control group and the observation group according to the drawing method of random sampling.The patients in the control group were give noxytocin,kneading uterine and other conventional treatment while the patients in the observation group were given hemabate injection250ug/times,based on of the treatment of the control group.The amount of postpartum hemorrhage of the patients in the two groups of patients was compared after two hours and twenty four hours of birth.The total effective rate,incidence of intrauterine packing with gauze and adverse reaction of the patients in two groups were compared. Results Two hours of the birth,the amount of postpartum hemorrhage of the patients in two groups had no difference significant （P 〉 0.05） but after the treatment, the amount of postpartum hemorrhage of the patients in the observation group was significantly lower than that of the control group （P 〈 0.05） twenty four hours after birth.The total effective rate in the observation group was significantly higher than that in control group （95.7%VS72.3%,x2=9.60,P=0.002）,The incidence of intrauterine packing with gauze was significantly lower than that of the control group （8.51%VS40.4%,x2=12.9,P=0.000）.The incidence of adverse reactions in the observation group was higher than that of the control group （10.6% VS 6.38%）,but the difference was not statistically significant （x2=0.547,P=0.357）. Conclusion Hemabate can effectively reduce bleeding caused by uterine atony in PHH patients and curative effect is good and safe,which is worth clinical application.