卡贝缩宫素与缩宫素联用预防药物流产后出血的临床研究

Carbetocin combined with oxytocin for prevention of bleeding after artificial abortion

目的 分析卡贝缩宫素与缩宫素联合用于预防药物流产后出血的临床效果。方法 选择110例行药物流产的意外怀孕患者进行观察,采用随机分组法分为观察组与对照组。观察组采用卡贝缩宫素联合缩宫素治疗,对照组单独采用缩宫素治疗,观察2组患者阴道出血量、月经恢复变化情况及疗效。结果 观察组患者治疗总有效率96.36%,显著高于对照组的78.18%,差异有统计学意义（P〈0.05）,观察组术后24 h阴道出血量、阴道出血停止时间、月经复潮时间、首次月经持续时间均低于对照组,差异有统计学意义（P〈0.05）,观察组患者阴道流血时间〈7 d占比30.91%,显著高于对照组的18.18%;阴道流血时间〉14 d占比3.64%,明显低于对照组的21.82%,差异有统计学意义（P〈0.05）,观察组患者阴道出血量〈月经量占比32.73%,高于对照组的20.00%;〉月经量占比9.09%,低于对照组的32.73%,差异有统计学意义（P〈0.05）,2组患者治疗前后性激素比较无明显差异。治疗后2组患者均明显改善,观察组患者孕酮水平低于对照组,雌二醇水平高于对照组,差异有统计学意义（P〈0.05）。对照组不良反应发生率为14例（25.45%）与观察组的8例（14.54%）比较,差异无统计学意义。结论 对药流患者术后给予卡贝缩宫素联合缩宫素治疗可以降低阴道出血量,缩短出血时间和月经恢复时间,疗效安全可靠。

Objective To analyze the carbetocin combined with oxytocin for prevention of bleeding after artificial abortion .Methods 110 cases of pregnant women undergoing artificial abortion were randomly divided into observation group and control group.Observation group were treated with carbetocin combined with oxytocin treatment, the control group were treated by oxytocin treatment, the negative blood loss, menstrual recovery changes and curative effect in two groups of patients were compared.Results The total efficiency of the observation group was 96.36%, was significantly higher than the control group 78.18%, the difference was statistically significant （P〈0.05）, the 24h negative bleeding volume, vaginal bleeding time, menstruation time, first menstrual duration in the observation group were lower than those in control group, the difference was statistically significant （P〈0.05）.The vaginal bleeding time less than 7d in observation group of patients accounted for 30.91%, was significantly higher than the control group 18.18%; the time of vaginal bleeding 〉14d accounted for 3.64%, significantly lower than the control group 21.82%, the difference was statistically significant （P〈0.05）.The vaginal blood〈menstrual volume accounted for 32.73% in the observation group, was higher than 20.00% in the control group, the vaginal blood 〉menstrual volume accounted for more than 9.09%, was lower than 32.73%in the control group, the difference was statistically significant （P〈0.05）.The sex hormone in two groups of patients before and after the treatment had no significant difference.The progesterone level in observation group was lower than the control group, estradiol level was higher than the control group, the difference was statistically significant （P〈0.05）, the adverse reaction rate in control group was 12.73% compared with 7.27% in the observation group, the difference was no statistically significant.Conclusion The abortion patients after treated with carbetocin combined with oxytocin treatment can reduce the amount of vaginal bleeding, shorten the bleeding time and menstrual recovery time, safe and reliable curative effect.