观察卡贝缩宫素预防阴道分娩产后出血的临床研究

Clinical study of carbetocin in preventing postpartum hemorrhage in vaginal delivery

目的 分析卡贝缩宫素预防阴道分娩产后出血的临床效果。方法 98例产后有出血倾向的产妇,通过数字随机方法分为研究组和对照组,每组49例。对照组应用缩宫素预防产后出血,研究组在对照组基础上加用卡贝缩宫素预防产后出血。比较两组产妇产后不同时间的阴道出血量、分娩前后的血红蛋白和心率、产后出血发生情况、用药前后炎性因子水平、不良反应发生情况。结果 研究组产妇产后2、24 h的阴道出血量分别为(169.87±18.16)、(199.38±21.46)ml,均明显低于对照组的(263.75±27.93)、(292.09±28.15)ml,差异显著(P<0.05)。分娩后,研究组产妇的血红蛋白(111.02±1.16)g/L相比对照组的(109.08±0.96)g/L更高,心率(74.89±5.83)次/min相比对照组的(81.92±7.11)次/min更低,差异显著(P<0.05)。研究组的产后出血发生率6.12%与对照组的20.41%相比更低,差异显著(P<0.05)。用药后,研究组的IL-10(28.10±2.32)ng/ml、IL-2(27.34±1.65)ng/ml与对照组的(36.25±3.56)、(32.44±2.14)ng/ml相比更低,差异显著(P<0.05)。研究组的不良反应总发生率2.04%与对照组的12.24%相比更低,差异显著(P<0.05)。结论 卡贝缩宫素能够有效预防阴道分娩产后出血,且药性持久、有较高的安全性。

Objective To analyze the clinical effect of carbetocin in preventing postpartum hemorrhage in vaginal delivery.Methods 98 cases of women with a tendency to postpartum hemorrhage were divided into a study group and a control group by random numerical table method,with 49 cases in each group.The control group was given oxytocin to prevent postpartum hemorrhage,and the study group was given carbetocin on the basis of the control group to prevent postpartum hemorrhage.Comparison was made on amount of vaginal bleeding at different times after delivery,hemoglobin and heart rate before and after delivery,the occurrence of postpartum hemorrhage,the level of inflammatory factors before and after medication,and the occurrence of adverse reactions between the two groups.Results The amount of vaginal bleeding at 2 and 24 h postpartum in the study group were(169.87±18.16)and(199.38±21.46)ml,which were significantly lower than(263.75±27.93)and(292.09±28.15)ml in the control group,and the difference was significant(P<0.05).After delivery,the study group had higher hemoglobin of(111.02±1.16)g/L than(109.08±0.96)g/L in the control group,and lower heart rate of(74.89±5.83)beats/min than(81.92±7.11)beats/min in the control group.The difference was significant(P<0.05).The incidence of postpartum hemorrhage(6.12%)in the study group was significantly lower than that in the control group(20.41%),and the difference was significant(P<0.05).After medication,the study group had IL-10 of(28.10±2.32)ng/ml and IL-2 of(27.34±1.65)ng/ml,which were lower than(36.25±3.56)and(32.44±2.14)ng/ml in the control group,and the difference was significant(P<0.05).The total incidence of adverse reactions in the study group(2.04%)was significantly lower than that in the control group(12.24%),and the difference was significant(P<0.05).Conclusion Carbetocin is effective in preventing postpartum hemorrhage in vaginal delivery,and it is long-lasting and has a high safety profile.