卡孕栓、米索前列醇联合缩宫素预防剖宫产产后出血的观察

目的 观察卡孕栓与缩宫素联合应用在剖宫产中预防产后出血的临床效果.方法 选取深圳市横岗人民医院2009年1月～2011年10月之间共600例剖宫产孕妇随机分成A、B、C3组,A组胎儿娩出后立即含服卡孕栓1mg,术后再予卡孕栓1 mg塞肛门；B组术后予米索前列腺素0.6 mg塞肛门；C组单用缩宫素.3组均在胎儿娩出后立即子宫肌层注射缩宫素20 u,同时静滴缩宫素20 u.观察3组术中、术后2h、24 h出血总量,产后出血率,术后肠鸣音恢复时间及药物的不良反应.结果 A组联合用药较B组和C组在术中、术后2h及24 h出血量显著减少,差异有统计学意义(P＜0.05)；发生严重产后出血需要输血者低于B、C组,差异有统计学意义(P＜0.05)；药物不良反应发生率也明显低于B组和C组(P＜0.05).结论 卡孕栓联合缩宫素在预防剖宫产产后出血效果良好,术中、术后出血率及严重产后出血率低,术后胃肠恢复快,不良反应少,且经济安全,起效快,维持时间长,值得在临床推广应用.

Observation of prophylactic use of carboprost suppositories and misoprostol combined with oxytocin on postpartum hemorrhage in cesarean section

OBJECTIVE To observe the clinical effects of carboprost suppositories and misoprostol combined with oxytocin on reduction of postpartum hemorrhage in cesarean section.METHODS From January 2009 to October 2011,the total of 600 cases of pregnant women who underwent cesarean section were randomized into group A,B and C.Group A was taken one milligram of carboprost suppositories immediately after delivery,and were given one more milligram of carboprost suppositories in the rectum;Group B was given 0.6 milligram of misoprostol in the rectum after delivery;Group C was given only with oxytocin.Three groups were all injected with 20 u of oxytocin to myometrium immediately after delivery,and along dripped with 20u of oxytocin.Then observed such as the total bleeding of intraoperative,two hours and 24 hours after operation,the rate of bleeding after delivery,the postoperative recovery time of borborygmus and the adverse reaction of drugs.RESULTS Compared with group B and C,group A was significantly reduced in the bleeding of intraoperative,two hours and 24 hours after operation,and there was a statistical significance(P﹤0.05),and the severe patients who need blood transfusion were less than group B and C,and the difference was statistically significant(P﹤0.05),and the adverse reaction rate of drugs was significant lower than group B and C(P﹤0.05).CONCLUSION The effects of prophylactic use of carboprost suppositories and misoprostol combined with oxytocin on postpartum hemorrhage in cesarean section is good,the bleeding rate of intraoperative and postoperative and severe postpartum hemorrhage is low,and the postoperative gastrointestinal recovered quickly and the side effects are less,on the other hand,it is economical and safe,work well and the effects can keep permanent,and it is worthy to be applied.