论文部分内容阅读
目的探讨预防性宫体注射卡前列素氨丁三醇防治高危产妇剖宫产术中出血的有效性与安全性。方法选取2015年1月-2016年12月四川省妇幼保健院产科收治的381例剖宫产术中具有产后出血高危因素的产妇为研究对象,按照宫体注射子宫收缩药物的不同分为3组,每组各127例。对照组产妇在胎儿娩出后立即给予20 IU缩宫素加入500 ml复方氯化钠液静脉输注;研究组1在胎儿娩出后立即给予20 IU缩宫素加入500 ml复方氯化钠液静脉输注后给予宫体注射250μg卡前列素氨丁三醇;研究组2在胎儿娩出后立即宫体注射250μg卡前列素氨丁三醇。对比3组产妇临床治疗效果、手术时间、术中及术后出血量,产后出血的发生率、产后出血产妇的止血情况及不良反应发生情况。结果对照组总有效率显著低于研究组1和研究组2,差异均有统计学意义(P<0.05);研究组1和研究组2总有效率比较,差异无统计学意义(P>0.05)。3组产妇手术时间比较,差异无统计学意义(P>0.05)。对照组术中、术后2 h、24 h出血量及产后出血发生率显著高于研究组1和研究组2,差异均有统计学意义(均P<0.05);研究组1术中、术后2 h、24 h出血量及产后出血的发生率与研究组2比较,差异无统计学意义(P>0.05)。研究组1和研究组2治疗性宫缩药的使用显著少于对照组,差异均有统计学意义(P<0.05)。所有产妇共发生不良反应29例,发生率为22.83%,对照组、研究组1、研究组2不良反应发生率分别为3.94%、11.18%、7.09%。结论卡前列素氨丁三醇防治高危产妇剖宫产术中出血效果较好,值得在临床上推广应用。
Objective To investigate the effectiveness and safety of prophylactic uterine injection of carboprost trometamol in the prevention and treatment of high risk maternal bleeding during cesarean section. Methods From January 2015 to December 2016, 381 pregnant women with high risk factors for postpartum hemorrhage undergoing cesarean section in Sichuan Maternal and Child Health Hospital were enrolled in this study. They were divided into 3 groups according to the uterine contractions: , 127 cases in each group. Control group of mothers immediately after delivery of the fetus given 20 IU oxytocin added 500 ml compound sodium chloride intravenous infusion; study group 1 immediately after delivery of the fetus given 20 IU oxytocin added 500 ml compound sodium chloride intravenous infusion After injection, intrauterine injection of 250 micrograms of carboprost tromethamine was given; in study group 2, 250 micrograms of carboprost tromethamine was injected into the uterine cavity immediately after delivery. The clinical efficacy, operative time, intraoperative and postoperative bleeding volume, the incidence of postpartum hemorrhage, the hemostatic status of maternal postpartum hemorrhage and the incidence of adverse reactions were compared between the three groups. Results The total effective rate of the control group was significantly lower than that of the study group 1 and the study group 2 (P <0.05). There was no significant difference in the total effective rate between the study group 1 and the study group 2 (P> 0.05 ). There was no significant difference between the three groups in maternal operation time (P> 0.05). In the control group, the amount of hemorrhage and the incidence of postpartum hemorrhage at 2 h and 24 h after operation were significantly higher than those in Study Group 1 and Study Group 2 (all P <0.05). In Study Group 1, After 2 h, 24 h and the incidence of postpartum hemorrhage bleeding rate compared with the study group 2, the difference was not statistically significant (P> 0.05). The use of therapeutic tacrolimus in study group 1 and study group 2 was significantly less than that in control group, with significant differences (P <0.05). There were 29 adverse reactions in all mothers, the incidence rate was 22.83%. The adverse reactions in control group, study group 1 and study group 2 were 3.94%, 11.18% and 7.09%, respectively. Conclusion Carbaprost tromethamine prevention and treatment of high-risk maternal bleeding in cesarean section is better, it is worth in the clinical application.