垂体后叶注射液联合卡前列甲酯栓预防产后出血的临床研究

目的探究垂体后叶注射液联合卡前列甲酯栓防治产后出血的临床疗效。方法选取2016年11月—2017年12月于成都市西区医院分娩的产妇110例,将所有患者随机分为对照组和治疗组,每组各55例。对照组在胎儿前肩娩出后舌下含服卡前列甲酯栓1枚;治疗组在对照组治疗的基础上静脉注射垂体后叶注射液,6 U加入到5%葡萄糖注射液500 m L中,0.02~0.04 U/min。观察两组的临床疗效,比较两组患者的产后出血量、产后宫缩持续时间、子宫下降幅度、恶露持续时间和血清因子水平。结果治疗后,对照组和治疗组的总有效率分别为81.82%、96.36%,两组比较差异有统计学意义(P0.05)。与产后0.5 h比较,两组患者产后0.5~2 h、2~24 h出血量显著下降,同组比较差异具有统计学意义(P0.05);且治疗组产后0.5、0.5~2、2~24 h出血量显著低于同期对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组宫缩持续时间、子宫下降幅度均明显高于对照组,恶露持续时间显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清一氧化氮(NO)、一氧化氮合成酶(NOS)、脑钠肽(BNP)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组血清因子水平显著低于对照组,两组比较差异有统计学意义(P0.05)。结论垂体后叶注射液联合卡前列甲酯栓能有效预防产后出血,降低出血量,改善子宫收缩,促进产后恢复,具有一定临床推广意义。

Clinical study on Posterior Pituitary Injection combined with Carboprost Methylate Suppositories in prevention of postpartum hemorrhage

Objective To investigate the clinical efficacy of Posterior Pituitary Injection combined with Carboprost Methylate Suppositories in prevention of postpartum hemorrhage. Methods Delivery women (110 cases) in Chengdu Western Hospital from November 2016 to December 2017 were randomly divided into control and treatment groups, and each group had 55 cases. Women in the control group were sublingual administered with one Carboprost Methylate Suppositories after delivery of the front shoulder of the fetus. Women in the treatment group were iv administered with Posterior Pituitary Injection on the basis of the control group, 6 U added into 5% glucose injection 500 mL, 0.02-0.04 U/min. After treatment, the clinical efficacies were evaluated, and the amounts of postpartum bleeding, duration of uterine contraction, the extent of uterine descent, the duration of lochia and serum factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.82% and 96.36%, respectively, and there was difference between two groups (P < 0.05). Compared with 0.5 h after delivery, the amounts of postpartum bleeding in two groups were significantly decreased at 0.5-2 h and 2-24 h after delivery, and the difference was statistically significant in the same group (P < 0.05). And at 0.5, 0.5-2, and 2-24 h after delivery, the amounts of postpartum bleeding in the treatment group were significantly lower than those in the control group at the same time, with significant difference between two groups (P < 0.05). After treatment, duration of uterine contraction and the extent of uterine descent in the treatment group were significantly higher than those in the control group, but the duration of lochia in the treatment group were significantly lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the levels of NO, NOS, and BNP in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the levels of serum factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Posterior Pituitary Injection combined with Carboprost Methylate Suppositories can effectively prevent postpartum hemorrhage, reduce the amount of postpartum bleeding, improve uterine contraction and promote the postpartum recovery, which has a certain clinical application value.