卡前列甲酯栓预防产后出血的临床研究

目的：探讨卡前列甲酯栓预防产后出血的效果。方法：选择３６０例正常足月妊娠阴道分娩者，随机分为试验组和对照组。试验组２６０例，在胎儿娩出后分别向阴道或直肠置入卡前列甲酯栓１ｍｇ，各１３０例；对照组１００例，在胎儿前肩娩出后分别经臀部肌肉或肘正中静脉注射催产素１０ＩＵ，各５０例，观察产后２小时内的出血量。结果：产后２小时内平均出血量，试验组中阴道给药及直肠给药者分别为１４６．４ｍｌ及１３４．２ｍｌ；对照组肌内注射及静脉注射催产素者出血量分别为２６７．９ｍｌ及２１０．６ｍｌ。试验组与对照组相比，差异有极显著性（Ｐ＜０．０１）；而试验组阴道与直肠给药者比较，差异无显著性（Ｐ＞０．０５）。结论：卡前列甲酯栓具有比催产素更强的子宫收缩作用，能减少产后出血量，而经直肠给药方法更为简便，更适于向农村基层推广。

Clinical Study on Reduction of Postpartum Bleeding by Methyl Carprost Suppository

Objective: To observe the effects of methyl carprost suppository on postpartum bleeding in normal parturients. Methods: Three hundred and sixty normal parturients were randomized into study group ( n =260) and the control group ( n =100). Parturients in study group were administered methyl carprost suppository tents either vaginally ( n =130) or via the rectum ( n =130). The controls were given 10IU oxytocin immediately after the delivery of anterior shoulder of the fetus either intramuscularly ( n =50) or intravenously ( n =50). The amount of bleeding with in 2 hours postpartum was measured. Results: The mean amount of bleeding for parturients who received vaginal or rectal methyl carprost was 146.4ml and 134.2ml, respectively. In contrast, the mean amount of bleeding for parturients who received oxytocin intramuscularly or intravenously was 267.9ml and 210.6ml, respectively. The differences in the amount of bleeding between the two groups were statistically significant ( P <0.01) , whearas differences between the routes of drug administration within each group were not significant ( P >0.05). Conclusion: Methyl carprost suppository is more effective than oxytocin in controlling postpartum bleeding. Drug administration through the rectum is easy to perform and, therefore, suitable for use in rural areas.