卡前列素氨丁三醇在前置胎盘剖宫产术中的应用价值

目的 探讨卡前列素氨丁三醇在前置胎盘剖宫产术中的应用价值,以期能为前置胎盘剖宫产术中及术后出血的预防临床用药选择提供参考.方法 将192例有明确剖宫产手术指征拟行剖宫产手术的产妇按照数字表格法分为观察组与对照组各96例,对照组在胎儿娩出后宫体肌注缩宫素20 U,观察组胎儿娩出后宫体肌注缩宫素20U,在胎盘娩出后再次肌注卡前列素氨丁三醇250 μg,如剥离面持续出血可观察15 min后重复使用一次,观察两组术中、术后2h、术后24h出血量、术中及术后输血及子宫复旧情况.结果 术中、术后2h、术后24h观察组出血量分别为（236.93± 104.28） ml、（311.48±78.21）ml、（364.82±63.18） ml,对照组分别为（327.18±134.85） ml、（408.69±102.41）ml、（462.93±84.37） ml,对照组出血量均大于观察组（P＜0.05）;宫腔纱布填塞率、术中及术后输血率、子宫复旧不良率观察组分别为12.50％、8.33％、13.54％,对照组分别为29.17％、22.92％、32.29％,观察组低于对照组（P＜0.05）;用药后不良反应发生率观察组为17.71％,对照组为12.50％,两组不良反应发生率比较差异无统计学意义（P＞0.05）.结论前置胎盘剖宫产术中使用卡前列素氨丁三醇能明显减少术中及术后出血量,促进术后子宫复旧,用药不良反应发生率未见明显增加.

Application value of Carboprost Tromethamine in cesarean section for placenta previa

Objective To investigate the application value of Carboprost Tromethamine in cesarean section for placenta previa,and to provide a reference for the clinical medication in the prevention of postoperative hemorrhage in cesarean section.Methods One hundred and ninety-two patients with clear cesarean delivery operation indications scheduled for cesarean section were divided into the observation group and the control group according to the digital maternal form method.The control group （n=96） received intramuscular injection of oxytocin 20 U after fetal childbirth,while the observation group （n=96） received intramuscular injection of oxytocin 20 U after fetal childbirth and intramuscular injection of Carboprost Tromethamine 250 μg after placenta,which was repeated if the stripping surface kept bleeding after 15 min of observation.The intraoperative bleeding,postoperative bleeding 24 h,2 h after surgery,uterine instauration,intraoperative and postoperative blood transfusion were observed.Results The bleeding volume of intraoperative and postoperative 2 h,24 h were （236.93±104.28） ml,（311.48±78.21） ml,（364.82±63.18） ml in the observation group,respectively,significantly less than （327.18±134.85） ml,（408.69± 102.41） ml,（462.93±84.37） ml in the control group （P〈0.05）.The intrauterine gauze packing rate,intraoperative and postoperative blood transfusion rate,uterine instauration defection rate in the observation group were 12.50%,8.33% and 13.54%,respectively,significantly lower than 29.17%,22.92% and 32.29% in the control group （P〈0.05）.The incidence of adverse reactions in the observation group after treatment was 17.71%,and that in the control group was 12.50%,with no statistically significant difference between the two groups （P〉0.05）.Conclusion The application of Carboprost Tromethamine in cesarean section for placenta previa can significantly reduce intraoperative and postoperative blood loss,promote postoperative uterine instauration,with no increase in the incidence of drug adverse reactions.