卡前列素氨丁三醇注射液和缩宫素在剖宫产产后出血中的应用

目的观察卡前列素氨丁三醇注射液（欣母沛）和缩宫素在预防和减少剖宫产产后出血的疗效及其不良反应比较。方法选择2013年11月至2014年3月同济大学附属第一妇婴保健院足月妊娠并行子宫下段剖宫产术的40例产妇为研究对象,并按胎儿娩出后宫体注射药物的不同,将剖宫产术中使用卡前列素氨丁三醇注射液的20例产妇纳入Ⅰ组,将术中使用缩宫素的20例产妇纳入Ⅱ组。观察两组产妇的手术情况和生命体征变化情况。两组产妇年龄、孕龄、体质量等一般情况比较,差异无统计学意义（P〉0.05）。本研究遵循的程序符合同济大学附属第一妇婴保健院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书。结果Ⅰ组产妇术中出血量显著少于Ⅱ组,两组比较,差异有统计学意义（P〈0.05）。两组产妇用药10min后生命体征变化情况比较,差异有统计学意义（P〈0.05）。Ⅰ组产妇恶心、呕吐、胸闷和颜面潮红等药物不良反应发生率显著高于Ⅱ组,两组比较,差异也有统计学意义（P〈0.01）。结论卡前列素氨丁三醇注射液用于剖宫产术能有效的减少产后出血,但该药物使用时应预防和避免其药物不良反应的发生。

Observation on Carboprost Tromethamine and Oxytocin for Reduction of Hemorrhage in Caesarean Section

Objective To observe the effect of carboprost tromethamine（hemabate）and oxytocin in cesarean section for preventing and reducing the intraoperative bleeding and compare their adverse reaction.Methods From November 2013 to March 2014,a total of 40 parturient women underwent cesarean section were included in the study.They were randomly divided into groupⅠ（20 cases using carboprost tromethamine injection）and groupⅡ（20 cases using oxytocin）according to different drugs for the injection into their uterine corpus immediately after fetal disengagement.There were no significant differences in maternal age,gestational age,body weight in general between two groups（P〉0.05）.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Shanghai First Maternity and Infant Hospital.Informed consent was obtained from each participants.Results The amount of blood loss during cesarean section in groupⅠ was obviously lower than that of groupⅡ（P〈0.05）.There were significant differences in vital signs at 10 min after treatment between two groups（P〈0.05）.The incidence rate of adverse reaction in groupⅠ was significantly higher than that of groupⅡ（P〈0.01）.Conclusion Carboprost tromethamine injection in caesarean operation can effectively decrease the intraoperative bleeding,but more attention should be paid on its adverse reaction.