缩宫素联合前列腺素类药物预防剖宫产产后出血及高危妊娠的临床研究

Clinical Study of Oxytocin Combined with Prostaglandins in the Prevention of Postpartum Hemorrhage and High Risk Pregnancy after Cesarean Section

目的阐述高危妊娠产妇以剖宫产形式分娩时予以缩宫素、前列腺素类药物联合治疗的临床效果。方法该次研究便利选取2016年3月—2019年9月于该院完成剖宫产分娩的高危妊娠产妇111例,将其随机分为3组,I组产妇分娩结束后单纯注射缩宫素,II组产妇分娩结束后注射缩宫素联合卡前列甲酯栓,III组产妇分娩结束后注射缩宫素联合卡前列素氨丁三醇。分别记录各组产妇术中及术后各时间出血量,分析差异情况,计算各组产妇发生产后出血率、输血率、附加止血措施率。观察各组产妇用药后发生不良反应情况类型,对比不良反应总发生概率。结果 III组产妇经缩宫素联合卡前列素氨丁三醇注射治疗后,术中出血量(337.94±20.14)mL、术后2 h出血量(94.68±7.57)mL、术后24 h出血量(61.77±3.05)mL均相较其他两组产妇更少,差异有统计学意义(t=32.790、22.150、19.490,P<0.05),同时,III组产妇、II组产妇发生产后出血情况的概率明显低于Ⅰ组,输血率、附加止血措施率均相较Ⅰ组更低,差异有统计学意义(P<0.05)。三组产妇注入药物后均为出现严重不良反应,总发生概率间较为相近,差异无统计学意义(P>0.05)。结论高危妊娠产妇经剖宫产手术后注入缩宫素及卡前列素氨丁三醇效果更佳,可减少出血量,预防产后出血问题,同时安全性高,值得临床运用推广。

Objective The clinical effect of combined treatment with oxytocin and prostaglandins in high-risk pregnant women during cesarean delivery was described.Methods The study selected 111 high-risk pregnant women who completed cesarean section delivery in the hospital from March 2016 to September 2019,were randomLy divided into 3 groups,groupⅠpuerpera childbirth after the pure injection of oxytocin,group II puerpera childbirth after the injection of oxytocin front row methyl bolt joint card,group III puerpera childbirth after the injection of oxytocin joint card other tromethamine,record each puerpera during and after surgery respectively and each time,blood loss,postoperative in different analysis,the calculation between groups incidence of postpartum hemorrhage and maternal blood transfusion rate,rate of additional hemostatic measures.Observe the types of adverse reactions after medication and compare the total probability of adverse reactions.Results Group III maternal by oxytocin joint card other tromethamine injections,intraoperative blood loss(337.94±20.14)mL,2 h after the bleedmg(94.68±7.57)mL,24 h after the bleeding(61.77±3.05)mL were less than the other two groups of maternal,the difference was statistically significant(t=32.790,22.150,19.490,P<0.05),at the same time,group III maternal,the probability of maternal postpartum hemorrhage happens II group was obviously lower than the groupⅠ,the rates of transfusion,additional hemostatic measures were lower than the groupⅠ,the difference was statistically significant(P<0.05).Serious adverse reactions occurred in all the three groups after drug injection,and the total occurrence probability was similar,the difference was not statistically significant(P>0.05).Conclusion After cesarean section,the injection of oxytocin and carboprost into high-risk pregnant women is more effective,which can reduce the amount of bleeding and prevent postpartum bleeding.At the same time,it has high safety and is worthy of clinical application.