卡贝缩宫素、米索前列醇和缩宫素对预防选择性剖宫产产后出血的疗效观察

目的:比较卡贝缩宫素、米索前列醇和缩宫素对预防选择性剖宫产产后出血(PPH)的有效性和安全性。方法:纳入2011年3月-2014年6月单胎妊娠拟行剖宫产产妇309例,随机性分为卡贝缩宫素组、米索前列醇组和缩宫素组,观察宫缩乏力需额外宫缩剂使用率。结果:卡贝缩宫素组在500~1000ml出血量、1000ml出血量、血红蛋白降低量和额外宫缩剂的使用率等方面均低于米索前列醇组和缩宫素组,PPH相对发生风险均低于缩宫素组和米索前列醇组(均P0.001);米索前列醇组热感、金属味、发烧和颤抖不良反应发生率最高(P0.001);卡贝缩宫素组腹痛的发生率最高(P0.001)。结论:卡贝缩宫素组额外宫缩剂的使用率低于其它两组,预防剖宫产后宫缩乏力和产后出血效果优于米索前列腺醇和缩宫素。

The effectiveness of carbetocin,misoprostol and andoxytocin for preventing postpartum hemorrhage in women with selective cesarean section

Objective:To compare the effectiveness and safety of carbetocin,misoprostol,and oxytocin for preventing postpartum hemorrhage (PPH) of women experienced selective cesarean section.Methods:From March 2011 to June 2014,total of 309 women with single pregnancy wanted to cesarean delivery were randomly divided into carbetocin group,misoprostol group and oxytocin group.The Usage of additional uterotonic because of uterus contractions fatigue was compared among the three groups.Results:The amount of blood loss of 500-1000 mL,amount of blood loss ＞1000 mL,hemoglobin levels decreased,and rate additional uterotonic using of women in carbetocin group were significantly lower than those of women in misoprostol group and oxytocin group(P＜0.001).Besides,the risk rate of PPH in carbetocin group was significant lower than that in both oxytocin group and misoprostol group (P＜0.001) The incidence of heat sensation,metallic taste,fever,and shivering of women in misoprostol group were the highest among the three groups(P＜0.001),and the incidence of abdominal pain was highest in carbetocin group (P＜0.001) Conclusion:Additional uterotonics using of women in carbetocin group were lower than that of women in the other two groups.Carbetocin was superior to misoprostol and oxytocin for preventing of uterine atony and PPH.