118例宫缩乏力性产后出血的治疗分析

目的 对卡前列素氨丁三醇注射液治疗宫缩乏力性产后出血的临床疗效进行观察.方法 回顾性分析118例宫缩乏力性产后出血患者的临床资料,按照治疗方法不同分为对照组（68例）和观察组（50例）,对照组采取常规治疗,观察组在常规治疗的基础上采用卡前列素氨丁三醇注射液治疗,对两组产后2,24h出血量、第三产程及治疗效果进行观察和比较.对照组治疗无效患者采取卡前列素氨丁三醇注射液治疗,所有患者若多次经重复注射卡前列素氨丁三醇注射液无效,应立即行手术治疗,并注意观察卡前列素氨丁三醇注射液治疗患者的不良反应.结果 对照组2,24h产后出血量分别为（676±86）,（751±70）ml,显著高于观察组的（238±62）,（281±56）ml,差异有统计学意义（P＜0.05）;且对照组第三产程时间为（5.1±1.9）h,显著长于观察组的（2.1±1.4）h,差异有统计学意义（P＜0.05）;对照组经常规治疗后47例患者停止大出血,其总有效率为69.1％（47/58）,而观察组总有效率为96.0％（48/50）,两组比较差异有统计学意义（P＜0.05）;对照组治疗无效的21例患者接受卡前列素氨丁三醇注射液治疗后,其总有效率为95.2％（20/21）.卡前列素氨丁三醇注射液治疗后的71例患者,血压上升2例,面部潮红2例,轻度头痛1例,腹泻3例,恶心、呕吐3例,共11例,其发生率为15.5％（11/71）,但均较轻微,给予对症治疗后均在24h内缓解,并无其他严重不良反应.结论 卡前列素氨丁三醇注射液用于治疗宫缩乏力性产后出血临床效果显著,安全性高,值得临床推广.

Treatment analysis of 118 patients with postpartum hemorrhage due to uterine inertia

Objective To observe the curative effects of carboprost tromethamine injection in treatment of postpartum hemorrhage due to uterine inertia.Methods The clinical data of 118 patients with postpartum hemorrhage due to uterine inertia were analyzed retrospectively.The patients were divided into control group （68 cases） and observation group （50 cases） by treatment method.The patients in control group were given conventional treatment while the patients in observation group were given carboprost tromethamine injection on basis of conventional treatment.The postpartum blood loss after 2,24 h after treatment,the third labor time and therapeutic effects in two groups were recorded and compared.The patients in control group took carboprost tromethamine injection if conventional treatment did not work and all patients should have surgery immediately if repeatedly carboprost tromethamine injection were invalid; adverse reactions of using carboprost tromethamine injection were closely watched.Results The postpartum blood loss after 2,24 h after treatment in control group was （676 ± 86）,（751 ± 70） ml,which was higher than that in observation group （238 ± 62）,（281 ± 56） ml],and there was significant difference （P 〈 0.05）.The third labor time in control group was （5.1 ± 1.9） h,which was longer than that in observation group （2.1 ± 1.4） h],and there was significant difference（P〈 0.05）.After conventional treatment with 47 patients stopped bleeding in control group,and the effective rate was 69.1% （47/58）,while the effective rate in observation group was 96.0% （48/50）,and there was significant difference （P 〈 0.05）.Twenty-one patients in control group accepted carboprost tromethamine injection after treatment,while the traditional therapy did not work,and the effective rate increased to be 95.2% （20/21）.Among carboprost tromethamine injection treatment of 71 patients,2 cases＇ blood pressure increased,2 cases had facial blushing,1 case with mild headache,3 cas