卡前列素氨丁三醇联合缩宫素治疗产后出血的临床观察

目的:观察卡前列素氨丁三醇联合缩宫素治疗产后出血的临床疗效和安全性。方法:将60例产后出血产妇按随机数字表法均分为对照组和观察组。对照组中经阴道分娩产妇在胎儿娩出后肌肉注射缩宫素20 u,剖宫产产妇在胎儿娩出后单次子宫体肌肉注射缩宫素20 u后,均给予缩宫素20 u加入5%葡萄糖注射液500 ml中静脉滴注,必要时可重复静脉滴注缩宫素;同时口服米索前列醇600 mg,qd。观察组产妇在对照组治疗的基础上给予卡前列素氨丁三醇0.25 mg宫体注射,视子宫收缩情况,可重复给予卡前列素氨丁三醇0.25 mg,每日总剂量不超过2.0 mg,两次用药时间需间隔15 min以上。观察两组产妇的临床疗效,宫缩强度、不同出血量者不同时间点的止血率及不良反应发生情况。结果:观察组产妇总有效率、宫缩强度、不同出血量者用药后5、10及15 min的止血率均显著高于对照组,差异均有统计学意义(P<0.05)。两组产妇不良反应发生率比较,差异无统计学意义(P>0.05)。结论:卡前列素氨丁三醇联合缩宫素治疗产后出血较单用缩宫素疗效更显著,且安全性较好。

Clinical Observation of Romethamine and Oxytocin in the Treatment of Postpartum Hemorrhage

OBJECTIVE： To observe clinical efficacy and safety of romethamine and oxytocin in the treatment of postpartum hemorrhage. METHODS： 60 delivery women with postpartum hemorrhage were randomly divided into control group and observa- tion group. In control group, puerperal underwent natural labor were given intramuscular injection of oxytocin 20 u after delivery of fetus, and puerperal underwent caesarean section were given intrauterine injection of oxytocin 20 u after delivery of fetus; and then all of them received intravenous dripping of oxytocin 20 u added into 5% Glucose solution 500 ml, and intravenous injection of oxytocin repeatedly and oral dose of misoprostol 600 mg if necessary, qd. Observation group was additionally given intrauterine in- jection of romethamine 0.25 mg on the basis of control group, and repeated injection if necessary; total daily dose could not be more than 2.0 mg and medication interval was more than 15 rain. Clinical efficacy, the intensity of uterine contraction, hemostatic rates of patients with different amount of bleeding at different time and ADR were observed in 2 groups. RESULTS： The total effec- tive rate, the intensity of uterine contraction hemostatic rates of patients with different amount of bleeding 5, 10 and 15 min after medication in observation group were significantly higher than in control group; there was statistical significance （P〈0.05）; there was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Romethamine and oxytocin is more effective and safer than oxytocin alone in the treatment of postpartum hemorrhage.