卡前列甲酯栓配伍催产素预防高危产妇产后出血的临床分析

目的 观察卡前列甲酯栓配伍催产素预防阴道分娩高危产妇产后出血的临床效果.方法 将足月阴道分娩高危产妇400例完全随机分为观察组和对照组,各200例.观察组高危产妇于胎儿娩出后,肌内注射催产素20 U,并给予卡前列甲酯栓l mg塞肛；对照组仅肌内注射催产素20.U.观察2组产妇第三产程时间及产后2、24h出血量和产后出血发生率,以及用药后血压、脉搏的变化及药物不良反应.结果 观察组第三产程时间、产后2h出血量、产后24h出血量及产后出血发生率均明显少于对照组[(7.6±2.8)min比(11.5±2.9) min,(196±45) ml比(304±38) ml,(256±50) ml比(379±44)ml,3.5％ (7/200)比10.5％(21/200)],差异均有统计学意义(均P＜0.05).2组产妇治疗前后血压、脉搏差异无统计学意义(P＞0.05).观察组有10例出现轻微腹泻,3例出血、恶心,对照组未出现明显不良反应.结论 卡前列甲酯栓配伍催产素对预防及减少高危产妇产后出血安全、有效.

Effect of methylcarprost suppositories combined with oxytixin on prevention of high-risk maternal postpar- tum hemorrhage

Objective To observe the clinical effect of carboprost methylate suppository combined with oxy- tocin on prevention of high-risk maternal postplartum hemorrhage after transvaginal delivery. Methods All 400 transvaginal delivery high-risk maternal were randomly divided into control group and observation group （200 cases each group）. The control group after delivery were given oxytocin 20 U by intramuscular injection. On the basis of the control group, the observation group put another 1 mg carboprost mertrylate suppositroies into rectum. The minutes of the third stage of labor, the hemorrhage quantity at 2, 24 h after deliver, the incidence rate of postpartum hemor- rhage, blood pressure, pulse rate and adverse reaction were observed. Results The minutes of the third stage of la- bor, postpartum hemorrhage volume in 2, 24 h after deliver and the incidence of postpartum hemorrhage in observa- tion group were significantly lower than the control group [ （ 7.6 ＋ 2.8 ） min vs （ 11.5 ＋ 2.9） min, （ 196 45 ） ml vs （304 ＋38）m1,（256 ~50）ml vs（379 44）ml,3.5% （7/200） vs 10.5% （21/200）, P 〈0.05]. Ten cases had mild diarrhea and 3 cases had nausea in observation group, while there were no obvious adverse reaction in control group. Conclusion The efficacy of carboprost combined with oxytocin in prevention of high-risk maternal postpar- tum hemorrhage is safe and efficient.