卡前列素氨丁三醇预防前置胎盘产后出血临床观察

目的 探讨卡前列素氨丁三醇预防前置胎盘产后出血疗效.方法 2007年12月至2011年11月因前置胎盘行剖宫产手术患者192例完全随机分为研究组与对照组,各96例.剖宫产术中,胎儿娩出后吸尽残余羊水.2组均予5%葡萄糖注射液500 ml加缩宫素20 u静脉滴注.研究组于子宫体注射卡前列素氨丁三醇250μg;对照组于子宫体部注射缩宫素20 U,口服米索前列醇400μg.胎盘剥离后的出血经负压吸引器吸引到有刻度的吸引瓶内,以计算出血量.经以上处理后仍有活动性出血者,采用官腔填塞纱条及可吸收线"8"字缝合创面.观察产后2、24 h出血量、产后出血发生率及药物不良反应发生情况.结果 研究组产后2、24 h平均出血量分别为(255.7±63.2)和(358.9±67.4)ml,对照组产后2、24 h平均出血量分别为(388.2±85.1)和(556.7±73.4)ml.研究组产后2、24 h平均出血量明显少于对照组,差异均有统计学意义(P<0.05).研究组96例中,17例发生产后出血,产后出血发生率为17.7%;其中2例因大部分胎盘植入而切除子宫.对照组96例中产后出血72例,产后出血发生率75.0%,其中4例因大部分胎盘植入而切除子宫.2组产后出血发生率比较,差异有统计学意义(P<0.05).2组均未见明显药物不良反应发生.结论 卡前列素氨丁三醇是预防前置胎盘产后出血的有效药物.

Abstract：

Objective To investigate the prophylactic treatment effect of carbopmst tromethamine(Hemabate)on postpartum hemorrhage in patients with placenta praevia.Methods Totally 192 patients who underwent cesarean gection for placenta praevia from December 2007 througe November 2010 were retrospectively analyzed.The patients were divided into hemabate group(n=96)and control group(n=96).In hemabate group,the body of utems was injected with carboprost tromethamine.Ahernatively,the body of uterus was injected with oxytocin.Misoprostol was taken orally in control group.Oxytocin was used in both groups.The loss volume of blood was observed.Postpartum hemorrhage rates were analyzed.Results The mean loss volume of blood at postpartum 2 hour and 24 hour in hemabate group were much lower than that in control group(P<0.05).The postpartum hemorrhage rate was significantly decreased in hemabate group than that in control group(17.7%versus 75.0%.P<0.05).Condusion The study suggests that hemabate can decrease the postpartum hemorrhage volume and reduce the incidence of postpartum hemorrhage over oxytocin and misoprostol.

Clinical observation of preventive effect of carboprost tromethamine on postpartum hemorrhage in patients with placenta praevia

Objective To investigate the prophylactic treatment effect of carbopmst tromethamine(Hemabate)on postpartum hemorrhage in patients with placenta praevia.Methods Totally 192 patients who underwent cesarean gection for placenta praevia from December 2007 througe November 2010 were retrospectively analyzed.The patients were divided into hemabate group(n=96)and control group(n=96).In hemabate group,the body of utems was injected with carboprost tromethamine.Ahernatively,the body of uterus was injected with oxytocin.Misoprostol was taken orally in control group.Oxytocin was used in both groups.The loss volume of blood was observed.Postpartum hemorrhage rates were analyzed.Results The mean loss volume of blood at postpartum 2 hour and 24 hour in hemabate group were much lower than that in control group(P<0.05).The postpartum hemorrhage rate was significantly decreased in hemabate group than that in control group(17.7%versus 75.0%.P<0.05).Condusion The study suggests that hemabate can decrease the postpartum hemorrhage volume and reduce the incidence of postpartum hemorrhage over oxytocin and misoprostol.