前列腺素类药物预防高危妊娠剖宫产产后出血的临床研究

Clinical observation on preventing from postpartum hemorrhage in high risk pregnancy cesarean section with prostaglandins

目的:探讨在对高危妊娠剖宫产产后出血的预防时,使用前列腺素类药物的临床效果及安全性。方法:选取2017年10月-2018年1月在广东省佛山市顺德区妇幼保健院就诊的120例高危妊娠孕妇为研究对象,所有患者均经产前检查及临床症状检查确诊为高危妊娠孕妇,采用随机数字表法将其分为三组,A组孕妇使用缩宫素进行治疗,B组孕妇使用前列腺素类药物治疗,C组孕妇在参考组孕妇治疗的基础上,使用卡前列素氨丁三醇进行治疗,观察三组孕妇产后出血情况及不良风险事件发生情况。结果:使用不同的药物对三组孕妇进行治疗以后,C组、B组孕妇的出血量明显低于A组,C组、B组孕妇的止血效果明显优于A组,A组的出血量明显较多、止血效果明显较差(P<0.05),差异具有统计学意义。但是在不良反应发生率上,A组孕妇、B组孕妇的不良反应发生率为17.5%,C组孕妇的不良反应发生率为15.0%,三组孕妇在不良反应发生率上对比不明显(P>0.05),不具有统计学意义。结论:在对高危妊娠剖宫产产后出血的预防时,使用前列腺素类药物相较于缩宫素有着较好的治疗效果,但使用缩宫素联合前列腺素药物治疗不仅可以降低生产过程中的出血量,同时该药物也有着显著的治疗效果,因此其可作为一种有效的药物在临床上应用推广。

Objective:To investigate clinical efficacy and safety of prostaglandin on postpartum hemorrhage in high risk pregnancy by cesarean section.Methods:120 pregnant women with high risk pregnancy in Shunde District,Foshan City,Guangdong Province from October 2017 to January 2018 were selected.All the patients were diagnosed as pregnant women with high risk by prenatal examination and clinical symptom examination.The pregnant women in group A were treated with oxytocin and patients in group B were treated with prostaglandin drugs.On the basis of treatment of pregnant women in the reference group,the pregnant women in group C were treated with carprostatin amitriol.Results:After treatment,the amount of bleeding in group B was significantly lower than that in group A,and the blood stopping effect in group B and C was obviously better than group A,and the amount of bleeding in group A was significantly higher than that in group B and C.The hemostatic effect was significantly worse(P<0.05),the difference was statistically significant.The incidence of adverse reactions in group A and group B was 17.5%,and that in group C was 15.0%.The incidence rate was not statistically significant,P>0.05.Conclusion:Prostaglandins had a better effect on the prevention from postpartum hemorrhage during cesarean section in high risk pregnancy.However,oxytocin combined with prostaglandin could not only reduce the amount of bleeding during production,but also had a significant therapeutic effect,so it could be used as an effective drug in the clinical application.