目的 观察卡贝缩宫素预防宫缩乏力性产后出血的临床疗效。方法 选择400例正常足月分娩的孕妇,分为两组,阴道分娩组200例,剖宫产组200例,将各组又分为卡贝缩宫素组和缩宫素组。卡贝缩宫素组:胎儿娩出后将卡贝缩宫素100 μg静脉滴注(滴斗入);缩宫素组:胎儿娩出后将缩宫素10 U静脉滴注(滴斗入),同时持续10 U入液体静脉滴注至产后2 h。比较卡贝缩宫素组和缩宫素组产时(术时)、产后(术后)2 h及产后(术后)24 h的出血量。孕妇分娩前和分娩24 h后血红蛋白变化。结果 卡贝缩宫素阴道分娩及剖宫产组均比缩宫素阴道分娩及剖宫产组产时、产后2 h及产后24 h平均出血量均少,差值分别约为:产时120 ml,产后约45 ml,产后24 h约170 ml,卡贝缩宫素阴道分娩及剖宫产组产后24 h血红蛋白下降值也均比缩宫素阴道分娩及剖宫产组低,差值分别约为10 g/L、15 g/L,对比差异均有统计学意义(P<0.05)。结论 卡贝缩宫素能有效预防和减少产后出血,疗效明显高于缩宫素。
Abstract
Objective To study the preventive effect of carbetocin on postpartum hemorrhage. Methods 400 pregnant women of normal term delivery were divided into two groups, 200 cases in vaginal delivery group, 200 in cesarean section group, each group was divided into carbetocin group and oxytocin group. The carbetocin group was given carbetocin 100 μg into the pot after the delivery of the fetus, while for the oxytocin group, oxytocin 10 u was given into the perfusion tube infusion immediately after the delivery of the fetus, 10u into intravenous perfusion lasting for 2 hours after the delivery. The amount of bleeding intrapartum (the surgery) ,within 2 hours and 24 hours after the delivery(after surgery) between the carbetocin group and the oxytocin group was compared. At the same time, the hemoglobin change before the delivery and 24 hours after the delivery was compared. Results 2 h post partum and 24 h postpartum average bleeding volumes in carbetocin vaginal delivery group and cesarean section group were smaller than those in oxytocin vaginal delivery group and cesarean section group:120 ml,poor value respectively at time of delivery, about 45 ml postpartum,about 170 ml 24 hours postpartum.24 h postpartum hemoglobin declining value was also lower than that in carbetocin vaginal delivery group and cesarean sestion group,10 g/L versus and 15 g/L,with significant differences (P<0.05).Conclusion Carbetocin can effectively prevent and reduce postpartum hemorrhage,its effect is significantly higher than that of oxytocin.
关键词
宫缩乏力 /
产后出血 /
卡贝缩宫素
Key words
uterine inertia /
postpartum hemorrhage /
carbetocin
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参考文献
[1] 曹泽毅. 中华妇产科学[M].北京:人民卫生出版社,2010:149.
[2] 李 力,易 萍.产后出血及其临床救治[J].中国实用妇科与产科杂志,2011,27(2):100-101.
[3] 张宏秀,孙丽洲,王美莲,等.卡贝缩宫素联合缩宫素预防阴道分娩产后出血效果分析[J].中国实用妇科与产科杂志,2012,28(10):767-769.
[4] 李桂莲. 卡贝缩宫素预防宫缩乏力性产后出血的临床观察[J].中国地方病防治杂志,2014,29(8):237.
[5] 沈磊芬.卡贝缩宫素防治剖宫产产后出血的临床观察[J].吉林医学,2013,33(34):7122.
[6] 王秀梅.卡贝缩宫素预防宫缩乏力性产后出血的临床观察[J].检验医学与临床,2014,11(5):673.
[7] Rosseland L A,Hauge T H,Grindheim G,et al.Changes in blood pressure and cardiac output during cesarean Delivery:the effects of oxytocin and carbetocin compared with placebo [J].Anesthesiology,2013,119(3):541-551.
[8] 李健和,曹俊华,周冬初,等.长效催产素受体激动剂卡贝缩宫素的药理作用与临床应用[J].中国新药与临床杂志,2012,31(3):134.
[9] 徐 笑.卡贝缩宫素预防产后出血的临床效果观察[J].海南医学院学报,2010,16(3):348.
[10] 黄燕萍,刘正平.巧特欣与欣母沛预防剖宫产产后出血的临床效果比较[J].中国妇幼保健,2008,23(9):1212-1213.