卡前列素氨丁三醇預防剖宮產產后出血的臨床療效觀察

摘要：目的 探討剖宮產術中宮體注射卡前列素氨丁三醇預防產后出血的臨床療效。

關鍵詞：卡前列素氨丁三醇；預防；剖宮產；產后出血

Clinical Investigation Observation of Preventive Effect of Carboprost Tromethamine on Postpartum Hemorrhage in Patients of Cesarean Section

TAO Zhong-e，WANG De-ling

（Department of Obstetrics，Tianjin the first center Hospital，Tianjin 300192，China）

Abstract：Objective To investigate the efficacy of carboprost tromethamine on postpartum hemorrhage in patients of cesarean section.Methods 100cases of pregnant women with indication of cesarean section in our hospital from Oct 2011 to Oct 2013 were divided into the observation group and control group，to prevate postpartum hemorrhage，patients in observation group were given Oxytocin and carboprost tromethamine，the patients in control group were given Oxytocin.The information of average 2 h and 24 h bleeding quantity of postpartum，the heincidence rate of postpartum hemorrhage and blood transfusion were collected and compared after the therapy.Results The bleeding quantity of 2 h postpartum of control group was （335.9±57.3）ml，while that of the observation group was（201.3±54.1）ml，the differences were significant（P<0.01）；The average decreased quantity of 24 h postpartum of control group was （421.4±73.4）ml，obviously higer than observation group.The incidence rate of postpartum hemorrhage and blood transfusion of control group was obviously higher than observation group，the differences were significant.Conclusion Carboprost tromethamine can obviously reduce blood loss after cesarean section.It can be recognized as a safe，efficient and convenient method in preventing postpartum hemorrhage after cesarean section.

Key words：carboprost tromethamine；preventing；cesarean section；postpartum hemorrhage

產后出血是指胎兒娩出后24h內失血量超過500ml，是分娩期嚴重并發癥，引起產后出血的主要原因是子宮收縮乏力，占產后出血的70%～80%[1-2]。因此，臨床上合理的使用子宮收縮劑對于產后出血的預防和治療尤為關鍵。為探討卡前列素氮丁三醇（欣母沛）的臨床療效，本文對2011年10月～2013年10月我院收治的100例產后出血的患者進行回顧性分析。

1 資料與方法

1.1一般資料 選取2011年10月～2013年10月我院有剖宮產指征且有產后出血高危因素（如雙胎、前置胎盤、胎盤早剝、子癇前期、巨大兒、羊水過多等）、無前列醇類過類藥物禁忌癥的孕婦100例，隨機分成兩組，各50例。兩組孕婦的年齡、孕周、產次級高危因素比較差異均無統計學意義（P>0.05），具有可比性（見表1）。

1.2 方法 所有患者均采用子宮下段橫切口剖宮產術，打開子宮下段，吸凈羊水，觀察組于胎兒娩出后宮體注射卡前列素氮丁三醇250μg+縮宮素20U促進子宮收縮，如果宮縮情況不佳，間隔15min后繼續給予欣母沛250μg，對照組只注射縮宮素20U，若宮縮不佳，繼續給予縮宮素20～50U。

1.3 評價指標 比較兩組患者術后2h，產后24h、產后出血發病率、輸血率。出血量由專人測量，方法為①面積法+容積法：血染紗布以10cm×10cm=10ml失血量，計算吸引器瓶內與手術臺上擦拭紗布失血之和；②稱重法：術前于產婦臀下放置一次性紙墊，術后擠壓宮底排出宮腔積陰道積血，紙墊稱重，按1.05g相當于1ml血液為標準，依此法累計計算產后2、24h出血量[3]。……