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

Comparison of Value of Misoprostol Combined with Romethamine in Preventing the Hemorrhage of High-risk delivery after the Cesarean Section

目的探讨米索前列醇与卡前列素氨丁三醇在高危产妇剖宫产产后出血预防中的应用价值。方法选择2015年1月—2018年5月于该院行剖宫产的78例高危产妇为研究对象,采用随机数表法分为两组,每组各39例。两组均于胎儿娩出后常规应用缩宫素,在此基础上,对照组将米索前列醇置入直肠5~6 cm左右进行塞肛治疗,观察组则采用肌肉注射卡前列素氨丁三醇治疗。观察两组止血效果、产后出血情况及术后不良反应的发生情况。结果观察组产后出血发生率5.13%、止血有效率94.87%,优于对照组的对照组20.51%、79.49%,差异有统计学意义(χ~2=4.129,P<0.05);观察组患者产后2、24 h阴道出血量分别为(224.17±48.62)mL、(312.77±74.02)mL,均低于对照组的(293.29±53.35)、(405.54±81.75)mL,差异有统计学意义(t=5.980、5.253,P<0.05);对照组产后24 h面部潮红、恶心呕吐、头痛、腹泻、寒战等总发生率17.95%,高于观察组的7.69%,但组间比较差异无统计学意义(χ~2=1.119,P>0.05)。结论卡前列素氨丁三醇在预防高危产妇剖宫产产后出血中的效果明显好于索前列醇,且具有较高的安全性。

Objective To study the application value of misoprostol combined with romethamine in preventing the hem- orrhage of high-risk delivery after the cesarean section. Methods 78 eases of high-risk delivery women for cesarean section in our hospital from January 2015 to May 2018 were selected and randomly divided into two groups with 39 eases in each, both groups used the routine oxytocin, while the control group used the anus therapy after placing the misoprostol into the rectum 5-6cm, and the observation group used the intramuscular injection of romethamine, and the hemostatic effect, postpartum hemorrhage and occurrence of postoperative adverse reactions were observed. Results The incidence rate of postpartum hemorrhage, hemostatic effective rate in the observation group were better than those in the control group （5.13%, 94.87% vs 20.51%, 79.49%）, and the differences were statistically significant （χ2=4.129, P〈 0.05） , and the 2h, 24h Vaginal bleeding volumes after delivery in the observation group were lower than those in the control group [（224.17±48.62）mL, （312.77±74.02）mL vs（293.29±53.35）mL, （405.54±81.75）mL], and the differences were statistically significant （t=5.980, 5.253, P〈 0.05） ; the total incidence rate of 24h facial flushing, nausea and vomiting, headache, diarrhea, chills after delivery in the control group was higher than that in the observation group （17.95% vs 7.69%）, and the difference was statistically significant （χ2=1.119, P〉0.05） . Conclusion The effect of misoprostol com- bined with romethamine in preventing the hemorrhage of high-risk delivery after the cesarean section is obviously bet ter than that of sustprostol, with higher safety.