高危二次剖宫产出血患者宫体注射欣母沛治疗的效果及不良反应

Treatment effect and adverse reactions of intrauterine injection of hemabate to high-risk secondary cesarean section hemorrhage patients

目的探讨高危二次剖宫产出血患者宫体注射欣母沛治疗的效果及不良反应。方法选取廊坊市人民医院2013年7月至2015年11月收治的94例高危二次剖宫产患者,欣母沛组47例与缩宫素组47例,分别于剖宫产术胎儿娩出后立即给予宫体注射欣母沛或缩宫素;观察并比较两组患者术中以及术后2 h、24 h的出血量,记录两组产后出血、输血或子宫切除、不良反应等发生情况。结果欣母沛组术中以及术后2 h、24 h出血量分别为(332.17±40.62)m L、(118.49±51.44)m L、(406.54±66.08)m L,均少于缩宫素组(P<0.05);欣母沛组出现产后出血、输血、休克、子宫切除发生率分别为6.38%、4.26%、0.00%、0.00%,均低于缩宫素组(P<0.05);欣母沛组不良反应发生率(10.64%)低于缩宫素组(14.89%)。结论欣母沛宫体注射可以明显减少高危二次剖宫产患者的出血量,减少因大出血造成的休克、输血、子宫切除等风险;其不良反应主要为恶心、呕吐、腹泻等胃肠反应,多为暂时性且较轻微。

Objective To investigate the treatment effect and adverse reactions of intrauterine injection of hemabate to high - risk secondary cesarean section hemorrhage patients. Methods 94 patients with high- risk secondary cesarean section were selected in Langfang People＇s Hospital from July 2013 to November 2015, divied into hemabate group （47 cases） and oxytocin group （47 cases ）. They were given intrauterine injection of hemabate and oxytocin prime immediately after childbirth of cesarean section. Observe and compare the bleeding amount of the two groups during and 2h, 24h postoperation, record postpartum hemorrhage, blood transfusion or hysterectomy, and record adverse reactions such as nausea, vomiting, gastrointestinal reaction and the occurrences. Results Bleeding amount of the hemabate group during and 2h, 24h postoperation were （332. 17 ± 40. 62） mL, （ 118.49 ±51.44） mL and （406. 54 ± 66. 08 ） mL which were significantly lower than the oxytocin group （ P 〈 0. 05 ） ; the incidence rates of postpartum hemorrhage, blood transfusion and shock were 6. 38% , 4. 26%, 0. 00% and 0.00% and was significantly lower than the oxytocin group （P 〈0. 05） ; The incidence of adverse reactions of the hemabate group（ 10. 64% ） was significantly lower than that of the oxytocin group（ 14. 89% ）. Conclusion Intrauterine injection of hemabate can significantly reduce the bleeding amount of high - risk secondary cesarean section hemorrhage patients, thus reduce occurrence of shock, blood transfusion and hysterectomy risk due to massive hemorrhage. Its adverse reactions mainly are nausea, vomiting, diarrhea and other gastrointestinal reactions, all temporary and mild.