卡前列腺素氨丁三醇应用时机对宫缩乏力性产后出血的防治效果观察

目的:探讨早期应用卡前列腺素氨丁三醇对剖宫产产妇宫缩乏力性产后出血的防治效果。方法:选取2012年3月-2017年7月本院行剖宫产且具有出血高危因素产妇90例,随机分为3组各30例。3组产妇均在胎儿娩出后立即予以缩宫素10U经宫体内注射,预防组同时注射卡前列腺素氨丁三醇250μg,选择组在宫缩乏力时加用卡前列腺素氨丁三醇250μg,对照组不予其他用药。比较3组产妇术中及产后2h、24h出血量、收缩压(SBP)、舒张压(DBP)及出血发生率,产后24h血红蛋白(Hb)降低值。结果:预防组产妇的术中、术后2h、24h出血量及产后24h内Hb下降值均低于另外两组(P0.05),产后出血率预防组(20.0%)治疗组(46.7%)对照组(60.0%)(P0.05);产后2h、24h时SBP、DBP比较3组间差异无统计学意义(P0.05);对照组不良反应率(3.3%)低于预防组(23.3%)和治疗组(20.0%)(P0.05),但均在短期内自行缓解,无须特殊处理。结论:剖宫产胎儿娩出后早期使用卡前列腺素氨丁三醇能够显著降低产后出血量,有效防治产后出血。

The effect of the application timing of hemabate for preventing and treating postpartum hemorrhage caused by uterine inertia

Objective:To explore the effect of early using hemabate for preventing and treating postpartum hemorrhage caused by uterine inertia after cesarean section.Methods:From March 2012 to July 2017,90 women experienced cesarean section with bleeding risk factors in Zhongda hospital were enrolled and randomly divided into three groups (30 cases in each group).All women in the three groups had received injection of oxytocin immediately after fetal delivery,women in the instant group had received hemabate 250μg immediately after fetal delivery,women in the selection group had received hemabate 250μg when uterine inertia,and women in the control group had not given hemahate.Among the three groups,the volume of bleeding,value of systolic blood pressure (SBP),diastolic blood pressure (DBP) of women intraoperative,2 hours and 24h hours postpartum were compared,the rate of postpartum hemorrhage was compared,and the amplitudes of hemoglobin (Hb) decreased of women 24h hours postpartum was also compared.Results:The volume of bleeding intraoperative,2 hours and 24h hours postpartum,and the rate of Hb decreased 24h hours postpartum of women in the instant group were significantly lower than those of women in the another two groups.The rate of postpartum hemorrhage of women in the instant group was 20.0％,which was significantly lower than that of women (46.7％) in the selection group (P＜0.05),and the rate of postpartum hemorrhage of women in the selection group was also significantly lower than that of women (60.0％) in the control group (P ＜ 0.05).The value of SBP and DBP of women had no significant differences among the three group (P＜0.05).The adverse reactions rate of women in the control group was 3.3％,which was significantly lower than that of women in the instant group (23.3％) and the selection group (20.0％)(P＜0.05).Conclusion:The early application of hemabate after fetal delivery by cesarean section can significantly reduce the valume and rate of postpartum hemorrhage caused by uterine inertia,which can effectively prevent and treatment postpartum hemorrhage.