欣母沛预防和治疗剖宫产术后出血的临床观察

Application of hemabate in prevention and treatment of cesarean section:clinical observation of postpartum hemorrhage

目的:观察欣母沛在预防和治疗宫缩乏力性剖宫产术后出血中的应用效果。方法:选择剖宫产术后有产后出血倾向的高危孕妇161例(包括双胎妊娠、巨大胎儿、前置胎盘),随机分为两组。欣母沛组(观察组83例):胎儿娩出后立即宫体注射250ug欣母沛;缩宫素组(对照组78例):胎儿娩出后宫体注射20 U缩宫素。比较两组术后2h及24h出血量、产后出血发生率、用药后起效时间及不良反应发生情况。结果:观察组产后2h及24h平均出血量明显少于对照组,产后出血发生率低于对照组,差异有统计学意义(P<0.05);观察组用药后起效时间为(4.5±1.0)min,明显短于对照组的(7.2±1.3)min,差异有统计学意义(P<0.05);观察组不良反应发生率为3.61%(3/83),明显低于对照组的12.82%(10/78),差异有统计学意义(P<0.05)。结论:预防性使用欣母沛有助于减少剖宫产术产后出血,起效时间快,安全性高,可在临床上推广。

Objectives： To observe the application effect of hemabate on preventing and treating cesarean section postpartum hemorrhage caused by uterine atony. Methods： 161 pregnant women with high risk factors of postpartum hemorrhage （twin pregnancy, macrosomia and placenta praevia） were selected and divided randomly into two groups： the Hemabate Group （the study group） which included 83 cases, and the Oxytocin Group （the control group） which included 78 cases. The study group was given hemabate of 250μg into uterine muscle after delivery, while the control group was injected with oxytocin 20U into uterine muscle immediately after delivery. The bleeding volume at 2h and 24h, the incidence of postpartum hemorrhage, the onset time and adverse reactions of the two groups were compared. Results ： The average blood loss at 2h and 24 h in the observation group was significantly less than the control group, and the incidence of postpartum hemorrhage was lower the control group, with statistically significant difference （ P 〈 0.05 ）. The onset time of the observation group was （4.5 ± 1.0） min, significantly shorter than the control group of （7.2 ±1.3 ） min, with statistical significance （ P 〈 0. 05 ）. The incidence of adverse reactions in observation group was 3.61% （3/83）, significantly lower than the control group of 12.82% （ 10/78 ）, with statistically significant difference （P 〈 0. 05 ）. Conclusion： Preventive use of hemabate can reduce postpartum hemorrhage in cesarean section, which is safe, acting fast and worth promotion in clinic.