卡孕栓对剖宫产术后子宫复旧的影响

Study on the effect of Carboprost Involution of Uterus after Cesarean Section

【目的】观察卡孕栓对剖宫产产后出血及产后子宫复旧的影响。【方法】选择本院140例足月妊娠近期未用过前列腺素，对前列腺素和催产素使用无禁忌的剖宫产孕妇，随机分为卡孕栓联合催产素组70例（研究组），催产素组70例（对照组）；二组孕妇剖宫产术中胎儿娩出后均予子宫肌壁注射催产素10u，10u加入生理盐水100mL中1h内滴完。研究组在常规应用催产素的基础上，在术中胎儿娩出后即刻经直肠置入卡孕栓1．0mg，术后4h后开始每12h使用卡孕栓0．5mg直肠置入，共4次；对照组回病房后10u催产素加入生理盐水500mL中常规滴速静脉滴注，每日一次，共2d。精确测量从胎儿娩出至产后48h内各时段出血量，所有孕妇剖宫产术后d4均由同一超声医师测量子宫长、宽、厚各径线长度，计算比较子宫体积大小。【结果】研究组分娩至产后2h、6h、12h、24h出血量，产后24-48h出血量，子宫体积大小均小于对照组，且两组相比较差异均有显著性（P〈0．05）。【结论】卡孕栓对减少产后出血量，促进子宫复旧，降低孕产妇死亡率具有重要意义。

[Objective]To observe the effect of Carboprost for postpartum hemorrhage and postpartum uterine involution after cesarean delivery.[Methods]140 cases of full-term pregnant women with cesarean delivery were chosen ,who had not use prostaglandin recently and had no taboo for prostaglandin and oxytocin taboo. They were further divided into two groups, the experiment group using Carboprost combined with oxytocin （70 cases）, and the control group using oxytocin （70 cases）. During cesarean section , both of the two groups were injected with 10 u oxytocin to uterine wall after the fetal delivery, and were given with 100 ml normal saline adding with 10 u oxytocin within 1 hour. Based on the routine use of oxytocin in operation , the experiment Group was injected with Carboprost 1.0mg per rectum immediately after the delivery, 4 h after operation Carboprost 0.5 mg rectal insertion was started and performed every 12h , a total of 4 times. In the control group, the 10u oxytocin was added into the normal saline 500ml , which was injected intravenously once a day for a total of 2D. Accurate amount of bleeding was measured from the time of fetus delivery upto 48 h later, D4 days after cesarean section, all pregnant women were measured by the same physician ultrasound on uterine length, width and thickness and the diameters of each length to calculate and compare uterine volume. [Results] Postpartum hemorrhage 2h, 6h, 12h, 24h ,24-48h and uterine volume of the experiment group were less than those of the control group, and the difference between the two groups was significant （ P 〈0.05）.[Conclusion]Carboprost is able reduce the amount of postpartum hemorrhage, promote uterine involution and plays an important role in reducing maternal mortality.