卡孕栓联合缩宫素预防瘢痕子宫阴道分娩产后出血的效果

Effect of Methyl Carboprost Suppositories combined with oxytocin on the prevention of postpartum hemorrhage in puerperae with scarred uterus undergoing vaginal delivery

目的探究卡孕栓不同时间给药联合缩宫素预防瘢痕子宫阴道分娩产妇产后出血的效果。方法选取126例瘢痕子宫阴道分娩产妇作为观察对象,采用简单随机化分组法分为观察组和对照组,每组63例。2组均在分娩过程中给予缩宫素,观察组于分娩前使用卡孕栓,对照组于分娩后使用卡孕栓。比较2组产妇分娩前、分娩2 h后凝血功能[D-二聚体(D-dimer,D-D)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)和血小板计数(platelet count,PLT)]变化,记录2组产后1 h、产后2 h和产后24 h出血量,比较2组分娩后的临床指标(子宫底下降速度、子宫收缩持续时间及恶露持续时间),记录2组分娩后3 d药物不良反应的发生情况。结果分娩2 h后2组的D-D、PT和PLT均显著下降,且观察组的D-D、PLT均低于对照组,FIB、子宫底下降速度显著高于对照组(P<0.05)。观察组产后1 h、产后2 h和产后24 h出血量均显著低于对照组(P<0.05)。观察组子宫收缩持续时间长于对照组,恶露持续时间短于对照组(P<0.05)。分娩3 d后2组药物不良反应发生情况比较差异无统计学意义(P>0.05)。结论卡孕栓联合缩宫素用于瘢痕子宫阴道分娩产妇止血效果较好,可有效减少产后出血的发生,且分娩前用药疗效优于分娩后用药。

Objective To explore the effect of different administration time of Methyl Carboprost Suppositories combined with oxytocin on preventing postpartum hemorrhage in puerperae with scarred uterus undergoing vaginal delivery.Methods 126 puerperae with scarred uterus undergoing vaginal delivery were enrolled and divided into observation group and control group by simple randomized grouping method,with 63 cases in each group.The both groups were given oxytocin during delivery.The observation group was given Methyl Carboprost Suppositories before delivery,while the control group was treated with Methyl Carboprost Suppositories after delivery.The changes in coagulation function[D-dimer(D-D),prothrombin time(PT),fibrinogen(FIB),platelet count(PLT)]before delivery and after 2 hours of delivery were compared between the 2 groups,and the differences in blood loss 1,2 and 24 hours after delivery in the 2 groups were recorded.The clinical indicators(the descending speed of uterine fundus,the duration of uterine contraction,and the duration of lochia)were compared between the 2 groups after delivery,and the occurrence of adverse drug reactions were recorded in both groups on the 3rd after delivery.Results 2 hours after delivery,the D-D,PT and PLT were significantly decreased or shortened in both groups,and the D-D and PLT in observation group were lower than those in control group,while the FIB and descending speed of uterine fundus were significantly higher than those in control group(P<0.05).The postpartum blood loss volumes in observation group 1,2 and 24 hours after delivery were significantly less than those in control group(P<0.05).The duration of uterine contraction in observation group was longer than that in control group,while the duration of lochia was shorter than that in control group(P<0.05).There was no statistical difference in adverse drug reactions between the 2 groups after 3 days of delivery(P>0.05).Conclusion Methyl Carboprost Suppositories combined with oxytocin has a good hemostatic effect in puerperae with scarred uterus undergoing vaginal delivery,and it can effectively reduce the occurrence of postpartum hemorrhage,and the efficacy of medication before delivery is better than that after delivery.