卡前列素氨丁三醇联合缩宫素预防剖宫产产后出血效果的影响因素分析

Analysis of impacting factors of preventive efficacy of carboprost tromethamine combined with oxytocin on postpartum hemorrhage after cesarean section

目的探讨卡前列素氨丁三醇联合缩宫素预防剖宫产产后出血效果的影响因素。方法选择2018年1~12月的100例具有产后出血高危因素拟行剖宫产产妇为研究对象,分为对照组与研究组,每组各50例。对照组采用缩宫素治疗方法(250 mL 0.9%氯化钠溶液+10 U缩宫素注射液混合液静脉滴注,经宫体肌注给予10 U缩宫素注射液),研究组予卡前列素氨丁三醇联合缩宫素治疗方法(250μg卡前列素氨丁三醇经宫体迅速肌注,给予250 mL 0.9%氯化钠溶液+10 U缩宫素注射液混合液静脉滴注)。比较两组的剖宫产产后出血发生率、产后出血量、产后不良反应发生情况。结果研究组患者的剖宫产产后出血发生率为4.00%,低于对照组的18.00%,差异有统计学意义(χ2=5.0051,P<0.05);研究组患者的产后2 h出血量为(251.85±50.35)mL,产后24 h出血量为(306.65±53.85)mL,均少于对照组的(302.85±52.65)mL、(353.65±50.45)mL,差异有统计学意义(t=4.0216、3.6589,P<0.05);研究组患者的产后不良反应总发生率为4.00%,低于对照组的18.00%,差异有统计学意义(χ2=5.005、P<0.05)。结论对具有产后出血高危因素拟行剖宫产产妇实施卡前列素氨丁三醇联合缩宫素治疗方案,可以有效减少剖宫产产后出血发生率及产后出血量,减少产后不良反应发生率,安全性明显,值得推广应用。

Objective To investigate the impacting factors of preventive efficacy of carboprost tromethamine combined with oxytocin on postpartum hemorrhage after cesarean section.Methods 100 pregnant women with high risk factors of postpartum hemorrhage who intend to undergo cesarean section from January to December 2018 were selected as the research objects,and they were divided into the control group(n=50)and the study group(n=50)according to the random lottery method.The control group was treated with oxytocin(250 mL 0.9%sodium chloride solution combined with 10 U oxytocin injection by intravenous drip,and 10 U oxytocin injection by intramuscular injection),while the study group was treated with carboprost tromethamine combined with oxytocin(250μg carboprost tromethamine was injected intramuscularly through uterus,and 250 mL 0.9%sodium chloride solution combined with 10 U oxytocin injection by intravenous drip).The incidence of postpartum hemorrhage,the volume of postpartum hemorrhage and the incidence of postpartum adverse reactions(ADRs)were compared between the two groups after cesarean section.Results The incidence of postpartum hemorrhage after cesarean section in the study group was 4.00%,which was lower than 18.00%in the control group,and the difference was statistically significant(χ2=5.005,P<0.05).The volume of hemorrhage in the study group was(251.85±50.35)mL at 2 hours postpartum and(306.65±53.85)mL at 24 hours postpartum,which were lower than(302.85±52.65)mL and(353.65±50.45)mL in the control group,and the differences were statistically significant(t=4.0216,3.6589,P<0.05).The total incidence of postpartum ADRs in the study group was 4.00%,which was lower than 18.00%in the control group,and the difference was statistically significant(χ2=5.005,P<0.05).Conclusion The treatment scheme of carboprost tromethamine combined with oxytocin for pregnant women with high risk factors of postpartum hemorrhage can effectively reduce the incidence of postpartum hemorrhage after cesarean section and volume of postpartum hemorrhage,and can effectively reduce the incidence of postpartum ADRs,which has obvious safety and is worthy of promotion and application.