卡前列素氨丁三醇用于预防瘢痕子宫剖宫产术后出血的临床研究

Clinical study of carboprost tromethamine to reduce hemorrage of scar uterine cesarean delivery

目的:探讨使用卡前列素氨丁三醇预防瘢痕子宫剖宫产术后出血的临床效果和经济成本。方法:采用前瞻性研究方法,将241例拟行剖宫产的瘢痕子宫孕妇随机分为两组,分别注射卡前列素氨丁三醇(卡前列素氨丁三醇组,126例)和生理盐水(对照组,115例),比较两组术中及术后出血量、产后出血发生率和血液制品输注率,比较两组住院费用及其构成,以及人力资源成本差异。结果:卡前列素氨丁三醇组术中及术后的出血量,以及产后出血和输入血液制品比率均较对照组减少(P<0.05);卡前列素氨丁三醇组住院费用并未显著增加(P>0.05),反而降低了使用血液制品、抗生素费用和护理费用,减少了手术时间、住院时间和家属误工时间(P<0.05)。结论:预防使用卡前列素氨丁三醇可减少瘢痕子宫剖宫产妇女术后出血量,且不增加医疗等总费用。

Objective： To explore the clinical effect of carboprost tromethamine to prevent abnormal hemorrhage of scar uterine cesarean delivery and cost. Methods： The study was a prospective controlled clinical trial. 241women experienced scar uterine cesarean delivery were divided randomized into two groups , 126 women was in carboprost tromethamine（CT） injection group and 115 women was in saline injection group. The amount of bleeding during and after operation, rate of postpartum hemorrhage，rate of blood transfusion, total hospitalization expense and human resource cost were compared in the two groups. Results： When compared to saline injection group, amount of bleeding during and after operation, rate of postpartum hemorrhage，and rate of blood transfusion were all much less in injection CT group （P〈0.05）. Though total hospitalization expense in CT injection group was same as in saline injection group （P〉0.05）, cost of drug and nursing were less. Furthermore, time of operation ,time of hospitalization and downtime of family members were all shorter （P〈0.05）.Conclusion： Carboprost tromethamine can reduce the amount of bleeding during and after operation of women with scar uterine cesarean delivery, and it do not increase total hospitalization expense.