卡前列素氨丁三醇联合缩宫素预防瘢痕子宫孕产妇剖宫产术后出血的疗效观察

目的探讨卡前列素氨丁三醇联合缩宫素预防瘢痕子宫孕产妇剖宫产术后出血的疗效及安全性。方法回顾性分析2014年1月至2016年1月住院分娩的120例瘢痕子宫孕妇的临床资料，采用卡前列素氨丁三醇联合缩宫素的孕妇60例为观察组，单用缩宫素的孕妇60例为对照组，观察两组止血效果及用药安全性。结果观察组术中出血量、术后2h出血量、术后24h出血量均明显少于对照组（P〈0．05），观察组产后出血的发生率明显低于观察组（P〈O．05）；两组的术后输血率、子宫切除率、手术切口感染率比较，差异无统计学意义（P〉0．05）；观察组术后排气时间、住院天数明显短于对照组，观察组住院费用明显少于对照组，差异均有统计学意义（P〈0．05）；观察组与对照组不良反应发生率分别为15％、10％，差异无统计学意义（P〉0．05）。结论对瘢痕子宫孕产妇行剖宫产术后，选用卡前列素氨丁三醇联合缩宫素预防及治疗产后出血，效果确切，不良反应发生率低且程度轻，该疗法值得在临床上推广应用。

Objective To investigate the efficacy and safety of the combination of carboprost tromethamine and oxytocin in preventing postpartum hemorrhage after cesarean section. Methods The clinical data of 120 cases of uterine scar pregnancy from January 2014 to January 2016 were retrospectively analyzed.60 pregnant women who were treated with the combination of carboprost tromethamine and oxytocin were selected as the observation group, and the control group was treated with oxytocin. The hemostatic effect and safety of the two groups were observed. Results In the observation group, the amount of intraoperative bleeding, postoperative 2h bleeding, postoperative 24h bleeding were significantly less than those in the control group （ P〈0.05 ） .The incidence of postpartum hemorrhage in the observation group was significantly lower than that in the observation group （ P〈0.05 ） .There was no significant difference between the two groups in the rate of postoperative blood transfusion, hysterectomy and incision infection （ P〉0.05 ） .The postoperative exhaust time, hospitalization time and cost of the observation group were significantly less than those of the control group, the difference was statistically significant （ P〈0.05 ） .The incidence of adverse reactions in the observation group and the control group were 15% and 10%, respectively. The difference was not statistically significant （P〉0.05） . Conclusion The effect of the combination of carboprost tromethamine and oxytocin in preventing and treating postpartum hemorrhage after cesarean scar pregnancy is obvious, and the incidence of adverse reactions is low and mild.This therapy is worthy of clinical application.