卡前列甲酯栓联合卡前列素氨丁三醇预防和治疗子宫收缩乏力性产后出血的临床效果与安全性

Clinical efficacy and safety of carboprost methyl ester suppository combined with carboprost tromethamine on prevention and treatment of postpartum hemorrhage due to uterine atony

目的观察卡前列甲酯栓联合卡前列素氨丁三醇预防和治疗子宫收缩乏力性产后出血的临床效果与安全性。方法选取2019年6—12月复旦大学附属中山医院青浦分院收治的114例子宫收缩乏力性产后出血患者,根据随机数字表法分为观察组与对照组,各57例。在缩宫素用药基础上,对照组发现出血后使用卡前列素氨丁三醇子宫肌内注射干预;观察组在对照组用药的基础上加用卡前列甲酯栓置入阴道深处干预。对比2组产后2、24 h出血量和围产期不良反应发生率。结果观察组产后2、24 h出血量均少于对照组[(167±39)ml比(186±42)ml、(180±40)ml比(216±45)ml],差异均有统计学意义(均P<0.05)。观察组与对照组不良反应发生率比较,差异无统计学意义[7.0%(4/57)比3.5%(2/57)](χ2=0.704,P=0.402)。结论卡前列甲酯栓联合卡前列素氨丁三醇用于预防和治疗子宫收缩乏力性产后出血的效果确切,不良反应少。

Objective To observe the clinical efficacy and safety of carboprost methyl ester suppository combined with carboprost tromethamine on prevention and treatment of postpartum hemorrhage due to uterine atony.Methods From June to December 2019,114 patients with postpartum hemorrhage due to uterine atony admitted to Qingpu Branch Hospital of Zhongshan Hospital Affiliated to Fudan University were selected.They were randomly divided into observation group and control group,with 57 cases in each group.On the basis of oxytocin,the control group was intervened by intramuscular injection of carboprost tromethamine in myometrium after bleeding;the observation group was intervened by carboprost methyl ester suppository into deep vagina on the basis of control group.The amount of postpartum hemorrhage at 2 and 24 h after delivery and the incidence of perinatal adverse reactions were compared between the two groups.Results The amount of bleeding in the observation group at 2 and 24 h after delivery were less than those in the control group[(167±39)ml vs(186±42)ml,(180±40)ml vs(216±45)ml],and the differences were statistically significant(both P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[7.0%(4/57)vs3.5%(2/57)](χ2=0.704,P=0.402).Conclusion The efficacy of carboprost methyl ester suppository combined with carboprost tromethamine on prevention and treatment of postpartum hemorrhage due to uterine atony is definite,with less adverse reactions.