缩宫素联合前列腺素类药物预防高危妊娠且行剖宫产产后出血的临床观察

Clinical Observation of Oxytocin Combined with Prostanoid Drugs for Preventing High-Risk Pregnancy and Postpartum Hemorrhage of Cesarean Delivery

目的探讨缩宫素联合前列腺素类药物对高危妊娠及剖宫产产后出血的预防效果。方法选取我院2013年5月至2014年5月期间收治的高危妊娠且行剖宫产产妇200例，随机分为缩宫素组（A组，65例）、缩宫素联合卡前列甲酯栓组（B组，65例）和缩宫素联合卡前列素氨丁三醇组（C组，70例）。观察三组术中、产后出血量以及输血率等指标。结果B、c组产妇术中、产后2h出血量显著低于A组（P〈0．05）。c组术中、产后2h、产后2-24h出血量均显著低于B组（P〈0．05）：B、C组的输血率、接受附加止血措施率和产后出血率均显著低于A组（P〈0．05）；三组不良反应发生率比较差异无统计学意义（P〉0．05）。结论在预防高危产妇产后出血上，缩宫素联合卡前列素氨丁三醇的效果显著，适用于经济条件较好的地区。缩宫素联合卡前列甲酯栓也有一定预防效果，可用于条件较差的基层医院。

Objective To explore the prophylactic effect of oxytocin combined with prostanoid drugs for high-risk pregnancy and postpartum hemorrhage of cesarean delivery. Methods 200 cases of pregnant women with high-risk pregnancy and cesarean delivery admitted to our hospital from May 2013 to May 2014 were selected and randomly divided into oxytocin group （group A, 65 cases）, oxytocin combined with methyl carboprost suppository group （group B, 65 cases） and oxytocin combined with romethamine group （group C, 70 cases）. The intraoperative and postpartum blood loss, blood transfusion rate and other indexes were observed. Results The intraoperative blood loss and 2 hours after delivery of group B and group C were significantly less than those of group A （P 〈0.05）. The intraoperative blood loss, 2 hours and 2 - 24 hours after delivery of group C were significantly less than those of group B （P〈0.05）. The blood transfusion rate, rate of taking additional measures to stop bleeding and postpartum blood loss rate of group B and group C were significantly lower than those of group A （P 〈0.05）. No statistical difference was found in the incidence of adverse reaction among three groups （P 〉0.05）. Conclusions The oxytocin combined with romethamine has significant effect on preventing postpartum blood loss of high-risk pregnant women, which is suitable for areas with better economic conditions. The oxytocin combined with methyl carboprost suppository also has a certain preventive effect, which can be used in basic level hospitals with poor conditions.