前列腺素类药物联合缩宫素预防高危妊娠剖宫产产后出血效果观察

    Clinical effect of prostaglandins combined with oxytocin in the prevention of high risk pregnancy and postpartum hemorrhage after cesarean section

    • 摘要:
      目的探讨卡前列素氨丁三醇或卡前列甲酯栓联合缩宫素对高危妊娠行剖宫产产妇产后出血的预防效果。
      方法选择180例高危妊娠行剖宫产产妇作为研究对象,按照随机数表法分为A组和B组,每组各90例。A组在娩后给予10 U缩宫素静脉滴注和250 μg卡前列素氨丁三醇宫体肌内注射,B组给予10 U缩宫素静脉滴注和1 mg卡前列甲酯栓舌下含化。对2组产后各时间段出血量、产后出血率、输血率、附加止血措施干预率和不良反应发生情况进行观察和比较。
      结果术中、术后2 h和术后24 h,A组产妇出血量均显著少于B组(P < 0.05~P < 0.01)。2组产妇产后出血发生率、输血率和附加止血措施干预率差异均无统计学意义(P>0.05);A组12例产后出血产妇平均出血量为(841.34±232.56)mL,B组17例产后出血产妇平均出血量为(857.62±227.37)mL,2组间差异无统计学意义(P>0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。
      结论卡前列素氨丁三醇和卡前列甲酯栓联合缩宫素对高危妊娠行剖宫产产妇产后出血均有较好的预防效果,不良反应较小。其中使用卡前列素氨丁三醇在减少出血量上具有一定的优势。

       

      Abstract:
      ObjectiveTo investigate the preventive effects of carboprost tromethamine or carboprost methylate combined with oxytocin on postpartum hemorrhage in high risk pregnant women treated with cesarean section.
      MethodsOne hundred and eighty high risk pregnant women treated with cesarean section were randomly divided into group A and group B(90 cases each group).Group A was intravenously injected with 10 U oxytocin combined with intramuscular injection 250 μg carboprost tromethamine, and group B was intravenously injected with 10 U oxytocin combined with 1 mg carboprost methylate by sublingual administration after delivery.The amount of bleeding, and rates of postpartum hemorrhage, blood transfusion, intervention of additional hemostasis and occurrence of adverse reaction were compared between two groups.
      ResultsThe intraoperative, postoperative 2 h and postoperative 24 h haemorrhage amount in group A were significantly less than those in group B(P < 0.05 to P < 0.01).The differences of the incidence of postpartum hemorrhage, and rates of blood transfusion and intervention of additional hemostatic measures between two groups were not statistically significnat(P>0.05).The average amount of postpartum bleeding in 12 cases of group A and 17 cases of group B were(841.34±232.56)mL and(857.62±227.37)mL, respectively, and the difference of which was not statistically significant(P>0.05).The difference of the incidence rate of adverse reaction between two gorups was not statistically significant(P>0.05).
      ConclusionsCarboprost tromethamine or carboprost methylate combined with oxytocin in treating postpartum hemorrhage in high-risk pregnant treated with cesarean section has good preventive effect and less side effects.Carboprost tromethamine has a certain advantage in reducing the amount of bleeding.

       

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