卡贝缩宫素及卡前列素氨丁三醇联合产后出血预测评分表预防产后出血的临床研究

Carbetocin & Romethamine Combined with Postpartum Hemorrhage Prediction Rating Scale in Preventing Postpartum Hemorrhage

目的：探讨卡贝缩宫素、卡前列素氨丁三醇结合产后出血预测评分表预防产后出血的临床效果，降低产后出血发生率。方法：采用改良“产后出血预测评分表”对产妇进行评估，评分〉7分归为高危组、5分～7分归为中危组、0分～4分归为低危组，每组收集40例产妇，三组产妇在胎儿娩出后均应用宫素注射液，中危组加用卡贝缩宫素注射液，高危组加用卡贝缩宫素注射液及卡前列素氨丁三醇注射液，观察治疗效果。结果：产后2h、产后24h子宫出血量及出血率相似，差异无统计学意义（P〉0.05）。低危组产妇产后24h内血红蛋白下降幅度为（4．03±0．78）g／L，中危组下降幅度为（4．28±0．80）g/L，高危组下降幅度为（4．74±0．84）g/L，三组比较差异无统计学意义（P〉0．05）。产前、产后2h及产后24h三组产妇收缩压、舒张压相似，差异无统计学意义（P〉0.05），产后2h及产后24h本组产妇收缩压、舒张压较产前略降低，但差异无统计学意义（P〉0.05）。三组产妇产后2h内子宫张力均为硬状态。结论：根据产后出血预测评分表评估结果，卡贝缩宫素及卡前列素氨丁三醇实施不同的给药方案，能有效预防高危产妇的产后出血。

Objective： To investigate the clinical efficacy of carbetocin ＆ romethamine combined with postpartum hemorrhage prediction rating scale in prevention from postpartum hemorrhage, and to reduce the incidence of postpartum hemorrhage. Methods： Puerperas were evaluated by modified ＂ postpartum hemorrhage prediction rating scale＂. Puerperas with scores 〉7′ were in high-risk group, those with scores of 5′-7′ were in middle-risk group, and those with scores of 0′-4′were low-risk group ; 40 puerperas were enrolled into each group. After fetal disengagement, all the puerperas used oxytocin injection, while the middle-risk group used carbetocin injection additionally, and the high- risk group used carbetocin injection and romethamine injection additionally. Results： The 3 groups had similar volumes and incidences of uterine hem- orrhage at 2h and 24h after delivery, respectively, and the differences were statistically insignificant （ P 〉 0. 05 ）. The hemoglobin decreasing amplitudes at 24h after delivery in the puerperas of the low-risk group, middle-risk group, and high-risk group were （4.03±0.78）g/L, （4.28±0.80） g/L, and （4.74±0.84）g/L, respectively, and the differences were statistically insignificant （ P〉0.05）. The puerperas of the 3 groups had similar systolic pressures and diastolic pressures before delivery, at 2h and 24h after delivery, respectively, and the differences were statistically insignificant （P〉0.05） ; the puerperas of the 3 groups had insignificantly lower systolic pressures and diastolic pressures at 2h and 24h after delivery than those before delivery （ P〉0. 05）. The puerperas of the 3 groups had hard uteruses within 2h after delivery. Conclusion： According to the results of postpartum hemorrhage prediction rating scale, carbetocin and romethamine can effectively prevent from postpartum hemorrhage in high-risk puerperas.