米索前列醇与卡前列素氨丁三醇预防剖宫产产后出血的效果比较

Comparing therapeutic effects of misoprostol and carboprost tromethamine in the prevention of postpartum hemorrhage after cesarean section

目的比较米索前列醇与卡前列素氨丁三醇预防高危产妇剖宫产产后出血的价值。方法选择有产后出血倾向的高危孕妇113例(包括瘢痕子宫、前置胎盘、双胎、巨大儿、羊水过多),按随机数字表法分为观察组58例和对照组55例,观察组给予0.4 mg米索前列醇塞肛治疗,对照组给予肌肉注射卡前列素氨丁三醇250μg。比较两组产后出血发生率、产后2 h和24h的出血量、输血率,止血时间、近远期并发症等。结果两组产后出血率比较差异无统计学意义(P>0.05);对照组产后2 h及24 h出血量、输血率、止血时间及子宫切除率均低于观察组,差异有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论与米索前列醇相比,卡前列素氨丁三醇在剖宫产术产后出血的防治效果更优,可减少产后出血量和输血率,减少并发症的发生。

Objective To compare the value of Misoprostol and carboprost tromethamine in the prevention and treatment of postpartum hemorrhage after cesarean section. Method 113 cases of high-risk pregnant women, include scar uterus,placenta previa,twin pregnan-cy ;macrosomia and hydramnios were randomly divided into 2 groups. 58 cases in group A were treated with Misoprostol, while 55 cases in group B were treated with carboprost tromethamine. The postpartum hemorrhage rate,the amount of bleeding at postpartum 2 h and 24 h,blood transfusion rate,hemostatic time and complications were compared between the two groups. Results There was no significant difference in the postpartum hemorrhage rate between the 2 groups （ P 〉 0. 05 ）. The amount of bleeding at postpartum 2 h and 24 h, blood transfusion rate and hemostatic time in group B were less than those of group A （P 〈0.05）. No significant difference was found in the incidence of adverse reactions between the 2 groups （P〉0.05 ） . Conclusion Carboprost tromethamine can prevent postpartum hemorrhage, which the effect is superior to that of misoprostol. It can reduce the rate of postpartum hemorrhage, blood transfusion rate and complications after cesarean section.