缩宫素联合卡前列素氨丁三醇预防剖宫产术后出血的疗效及对血流动力学的影响

Curative efficacy of oxytocin combined with hemabate on prevention of postpartum hemorrhage of cesarean section and its effect on hemodynamics

目的：探讨缩宫素联合卡前列素氨丁三醇预防剖宫产术后出血的疗效及对血流动力学的影响。方法选取2014年12月至2016年1月符合临床选取标准的102例产妇，根据入院先后顺序分为联合组和单一组，每组51例。单一组仅采用缩宫素，联合组采用缩宫素＋卡前列素氨丁三醇治疗。对比两组产妇产后出血发生率、术后不同时间段出血量、手术前后血流动力学水平变化情况及子宫复旧情况，并统计两组不良反应发生情况。结果联合组产后出血发生率（3.92％）低于单一组（21.57％），联合组术后2、24 h 时出血量[（226.41±46.69）、（304.48±75.22）ml]均显著少于单一组[（359.12±59.32）、（448.61±61.59）ml]，差异有统计学意义（P ＜0.05）。术后2 h 联合组舒张压[（69±20）mmHg，1 mmHg ＝0.133 kPa]、收缩压[（116±21）mmHg]显著高于单一组[（56±13）、（95±20）mmHg]，心率[（100±20）次/ min]低于单一组[（115±21）次/ min]，差异有统计学意义（P ＜0.05）。与单一组[（20.13±1.69）cm]相比，联合组宫腔深度[（15.11±1.32）cm]明显变浅，差异有统计学意义（ P ＜0.05）。联合组不良反应发生率为23.53％，单一组为21.57％，两组比较差异未见统计学意义（ P ＞0.05）。结论对接受剖宫产手术的产妇联合采用缩宫素和卡前列素氨丁三醇可有效降低术后出血发生率，显著减少术后出血量，有助于促进子宫复旧，且不会增加不良反应发生率，对舒张压等血流动力学指标影响较小，具有推广价值。

Objective To investigate the curative efficacy of oxytocin combined with hemabate on prevention of cesarean section postpartum hemorrhage and its effect on hemodynamics. Methods From December 2014 to January 2016, 102 pregnant women according to the clinical selection criteria were selected. According to the order of admission, they were divided into combination group and single group, with 51 cases in each group. The single group was treated with oxytocin, and the combination group was treated with oxytocin combined with hemabate. The postpartum hemorrhage rate, postoperative time bleeding volume, hemodynamic changes before and after the operation and uterine involution situation were compared, and the incidences of adverse reactions in the two groups were analyzed. Results The incidence of postpartum hemorrhage was lower in the combination group （3.92%） than that in the single group （ 21.57% ）, the amount of bleeding [ （ 226. 41 ± 46.69 ） ml, （ 304.48 ± 75.22） ml] were significantly less than that in the single group[ （359. 12 ± 59.32） ml, （448.61 ±61.59） ml] after 2 h and 24 h, the differences were significant （P 〈 0.05）. The diastolic blood pressure and systolic blood pressure of the eombination group [ （69 ± 20 ） mmHg, （116 ± 21 ） mmHg, 1 mmHg =0. 133 kPa] were significantly higher than those in the single group[ （56 ± 13） mmHg, （95±20） mmHg] at 2 hours after operation, and the heart rate[ （100 ±20） beat/mini was lower than that in the single group [ （ 115± 21 ） beat/rain ], the differences were significant （ P 〈 0. 05 ）. Comparing with single group[ （15.11 ± 1.32） cm], the depth of the uterine cavity of the combination group[ （20. 13±1.69） cm ] was significantly lower, and the difference was significant （ P 〈 0.05 ）. The incidence of adverse reactions in the combination group was 23.53%, the incidence rate of adverse reaction in the single group was 21.57%, and there was no significant difference between the two groups （ P 〉 0. 05 ）. Conclusions For delivery women with cesarean section, oxytocin combined with hemabate for prevention of cesarean section postpartum hemorrhage can effectively reduce the incidence of bleeding after the operation, significantly reduce the postoperative bleeding volume, promote uterine involution, and will not increase the incidence of adverse reactions, has little impact on the diastolic blood pressure and other indicators of hemodynamics, is worthy to promotion.