卡前列素氨丁三醇联合葡萄糖酸钙防治瘢痕子宫合并前置胎盘再次剖宫产产后出血的研究

目的 探讨卡前列素氨丁三醇联合葡萄糖酸钙对瘢痕子宫合并前置胎盘再次剖宫产产后出血的防治效果.方法 将四川省眉山市人民医院产科106例2014年2月至2016年2月瘢痕子宫合并前置胎盘并再次行剖宫产手术的产妇随机分为观察组和对照组各53例.对照组给予卡前列素氨丁三醇注射液,观察组在对照组治疗的基础上联合葡萄糖酸钙进行治疗.比较两组产后出血的发生率及术中、术后2h与24h的出血量,产前及产后血清Ca2+、血红蛋白(Hb)浓度的变化,记录两组的不良反应情况.结果 观察组产后出血率(χ2=5.671, P<0.05)、产后2h与24h的出血量明显低于对照组(t值分别为15.818、10.277,均P<0.05);两组产后血清Ca2+浓度均升高,Hb浓度均下降(观察组t值分别为10.255、2.589,对照组t值分别为 11.758、6.572,均P<0.05),而观察组产后血清Ca2+及Hb浓度均高于对照组(t值分别为10.332、1.331,均P<0.05).两组不良反应发生率无显著差异(χ2=0.153, P>0.05).结论 卡前列素氨丁三醇联合葡萄糖酸钙可以有效防治瘢痕子宫合并前置胎盘再次剖宫产产后出血,具有简便、高效、起效快及安全等优点,值得临床推广.

Research of carboprost tromethamine combined with calcium gluconate in preventing postpartum hemorrhage after cesarean section again in patients with scarred uterus and placenta previa

Objective To discuss the effects of carboprost tromethamine combining calcium gluconate in preventing and treating postpartum hemorrhage in repeated cesarean section in patients with scarred uterus and placenta previa.Methods Totally 106 cases with scarred uterus and placenta previa during February in 2014 to February in 2016 undergoing repeated cesarean section in People's Hospital of Meishan City were divided into control group and observation group with 53 cases in each group.The patients in the control group were injected carboprost tromethamine.Based on the treatment for the control group, patients in the observation group were additionally given calcium gluconate.The incidence of postpartum hemorrhage, amount of bleeding volume during and 2h and 24h after operation, changes of serum Ca2+ and hemoglobin (Hb) concentration in prenatal and postnatal period were compared between two groups.The adverse reactions of two groups were recorded.Results The incidence of postpartum hemorrhage (χ2=5.671, P<0.05) and bleeding volume 2h and 24h after operation of the patients in the observation group were significantly less than those in the control group (t value was 15.818 and 10.277, respectively, both P<0.05).The Ca2+ concentration in serum increased while Hb concentration decreased in two groups after delivery (tobservation value was 10.255 and 2.589, respectively, tcontrol value was 11.758 and 6.572, respectively, all P<0.05).But the Ca2+ and Hb concentrations in serum of patients in the observation group were higher than those in the control group (t value was 10.332 and 1.331, respectively, both P<0.05).There was no significant difference in adverse reactions between two groups (χ2=0.153, P>0.05).Conclusion Carboprost tromethamine combined with calcium gluconate is of great clinical effects in preventing and treating postpartum hemorrhage in repeated cesarean section in patients with scarred uterus and placenta previa.It is simple, efficient, fast and safe, which is worth to be spread in clinics.