【摘 要】目的:探讨卡前列甲酯栓联合缩宫素预防瘢痕子宫剖宫产产后出血的应用效果。方法:选取本院2016年10月-2017年12月期间行剖宫产手术的瘢痕子宫产妇84例,按入院先后顺序分为对照组与实验组。给予对照组产妇米索前列醇联合缩宫素治疗,给予实验组卡前列甲酯栓联合缩宫素治疗。结果:实验组产妇术中、产后2h、产后24h出血量均少于对照组,组间比较,差异具有统 计学意义(P<0.05);产前两组产妇血红蛋白水平比较,差异无统计学意义(P>0.05),产后实验组产妇血红蛋白水平为(70.15±10.54)g/L,高于对照 组的(58.14±8.35)g/L,差异具有统计学意义(P<0.05);实验组不良反应发生率为11.90%,低于对照组的33.33%,差异具有统计学意义(P<0.05)。结论:卡前列甲酯栓联合缩宫素在瘢痕子宫剖宫产产后出血中的应用效果显著。
【关键词】卡前列甲酯栓联合缩宫素;预防瘢痕子宫剖宫产产后出血;应用效果。
The effect of calprost methyl ester suppository combined with intrauterine to prevent postpartum hemorrhage after cesarean section
Abstract:objective:to explore the effect of calprost methyl ester suppository combined with oxytocin in preventing postpartum hemorrhage after cesarean section. Methods:84 cases of scar uterine parturients who underwent cesarean section between October 2016 and December 2017 in our hospital were selected,which were divided into control group and experimental group according to the sequence of admission. Patients in the control group were treated with misoprostol combined with oxytocin,and patients in the experimental group were treated with carprost methyl ester combined with oxytocin. Results:in the experimental group,the intraoperative,2h and 24h blood loss were lower than those in the control group,and the difference was of statistical significance(P<0.05).There was no statistically significant difference(P>0.05)in the comparison of hemoglobin levels between the two groups in prenatal and postnatal groups. The hemoglobin level of the two groups in postpartum group was 70.15 + 10.54 g/L,higher than that of the control group(58.14 + 8.35)g/L,and the difference was statistically significant(P<0.05).The adverse reaction rate was 11.90% in the experimental group,lower than 33.33% in the control group,and the difference was statistically significant(P<0.05).Conclusion:the application effect of carprost methyl ester suppository combined with intrauterine in postpartum hemorrhage of cesarean section with scar.
Keywords:carprost methyl ester suppository combined with oxytocin;Prevention of postpartum hemorrhage by cesarean section of scar;Application effect.
剖宫产率的逐渐提升在一定程度上使得瘢痕子宫妊娠女性数量有所增加,同时也加大了瘢痕子宫二次剖宫产概率[1]。受到术中粘连及瘢痕组织肌纤收缩能力减低的影响,会导致瘢痕子宫产妇子宫收缩乏力的情况,极易引发产后出血。现总结如下。
1.资料与方法
1.1一般资料
选取本院2016年10月-2017年12月期间行剖宫产手术的瘢痕子宫产妇84例为此次研究对象,按入院先后顺序分为对照组与实验组。对照组42例,年龄25-34岁,平均年龄(28.64±1.48)岁,孕周37-41周,平均(40.28±0.32)周;实验组42例,年龄24-36岁,平均年龄(28.73±1.46)岁,孕周38-41周,平均(40.34±0.28)周。两组产妇一般资料比较,差异无统计学意义(P>0.05),可进行对比。
1.2方法
对照组采用米索前列醇联合缩宫素治疗,给予患者米索前列醇片口服,0.6mg/次,后给予10U缩宫素+500mL5%葡萄糖静脉滴注;实验组采用卡前列甲酯栓联合缩宫素治疗,卡前列甲酯栓放置于直肠,1粒/次,后给予产妇10U缩宫素+500mL5%葡萄糖静脉滴注。
2.结果
两组产妇术中、产后2h及产后24h出血量比较,差异具有统计学意义(P<0.05),见表1。两组产妇产前血红蛋白水平比较,差异无统计学意义,产后实验组产妇血红蛋白水平高于对照组,比较差异具有统计学意义(P<0.05),见表2。实验组产妇不良反应发生率为11.90%,对照组为33.33%,组间比较,差异具有统计学意义(P<0.05)。
表1 两组产妇术中及产后出血情况比较
表2 两组产妇产前及产后血红蛋白水平比较
3.结果
产后出血是胎儿在出生后24h内产妇失血量多于500mL,是产妇在分娩期,严重的并发症之一。所以需要在产前后进行预防治疗,降低产后出血以及对产妇身体的影响[2]。
目前临床使用缩宫素进行预防产后出血。但缩宫素药效时间短,而且存在个体差异性。卡前列甲酯是前列腺素类衍生物,其半衰期长,药效时间久,可以弥补缩宫素的不足[3]。
综上所述,卡前列甲酯栓联合缩宫素在瘢痕子宫剖宫产产妇产后出血预防中的效果显著。
参考文献:
[1]韩叶,万成福,毛英. 卡前列甲酯栓联合宫缩素对瘢痕子宫剖宫产后出血的预防效果观察[J]. 深圳中西医结合杂志,2016,26(04):134-135.
[2]刘红艳. 卡前列甲酯栓预防瘢痕子宫剖宫产产后出血的临床效果研究[J]. 白求恩医学杂志,2016,14(03):361-362.
[3]祖元琪. 卡前列甲酯栓预防瘢痕子宫剖宫产产后出血的临床效果分析[J]. 中国卫生标准管理,2018,9(03):70-72.
论文作者:代琳
论文发表刊物:《中国医学人文》(学术版)2018年6月下第12期
论文发表时间:2018/11/26
标签:产妇论文; 瘢痕论文; 产后论文; 实验组论文; 前列论文; 子宫论文; 统计学论文; 《中国医学人文》(学术版)2018年6月下第12期论文;