卡贝缩宫素预防产后出血的临床效果观察

The Clinical Analysis of Carbetocin on Postpartum Hemorrhage Prevention

目的探讨卡贝缩宫素在临床运用中预防宫缩乏力性产后出血的疗效分析。方法选择2014年12月至2016年12月在我院就诊的宫缩乏力、产后出血高危因素的400例剖宫产孕妇,随机分为实验组200例和对照组200例。实验组:在胎儿娩出后立即静脉推注卡贝缩宫素100μg+0.9%生理盐水100 m L快速静脉滴注;对照组:于胎儿娩出后立即肌内注射催产素10 Iu,同时静脉滴注催产素20 Iu。比较两组产后2 h及24 h出血量、产后出血发生率、血红蛋白及不良反应情况。结果实验组比对照组产后2 h及产后24 h平均出血量减少,差异均有显著性(P<0.01),实验组产后出血发生率少于对照组,差异具有统计学意义(均P<0.05)两组产程中出血量差异无统计学意义(均P>0.05)。结论卡贝缩宫素预防产后出血具有起效快、出血量少、效果持久,是一种相对安全有效的方法,值得临床应用推广。

Objective To explore the curative effect of carbetocin in the prevention of postpartum hemorrhage caused by uterine inertia. Methods From December 2014 to December 2016,400 pregnant women with uterine inertia and high risk of postpartum hemorrhage in our hospital were randomly divided into the experimental group（ n = 200） and the control group（ n = 200）. In the experimental group,after the delivery,patients immediately received intravenous injection of carbetocin 100 μg＋0. 9% and intravenous infusion of normal saline 100 m L. In the control group,after the delivery of fetus,patients were immediately treated with intramuscular injection of oxytocin 10 Iu and intravenous infusion of oxytocin 20 Iu. The amount of bleeding,the incidence of postpartum hemorrhage,hemoglobin and the adverse reactions were compared between the 2 groups after delivery in 2 h and 24 h. Results The amount of bleeding in the experimental group was significantly less than that in the control group after delivery in 2 h and 24 h（ P 0. 01）.The incidence of postpartum hemorrhage in the experimental group was significantly lower than that in the control group（ P 0. 05）.There was no statistically significant difference（ P 0. 05） in the amount of bleeding during the stage of labor. Conclusion Carbetocin is a relatively safe and effective method in the prevention of postpartum hemorrhage with rapid response,less bleeding and lasting effect,which is worthy of clinical application.