卡贝缩宫素联合麦角新碱预防二次剖宫产产后出血的效果观察
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摘要
目的:观察卡贝缩宫素联合麦角新碱预防二次剖宫产产后出血的效果。方法:选取瘢痕子宫产妇200例,根据术中用药情况分成两组,观察组(100例)为卡贝缩宫素联合麦角新碱组,对照组(100例)为单用缩宫素组。结果:两组产妇术后2h出血量比较差异无统计学意义(P>0.05)。观察组术后24h出血量少于对照组,差异有统计学意义(P<0.05)。观察组产后出血发生率为3%,低于对照组的11%,差异有统计学意义(P<0.05)。术中额外用药率观察组为5%,明显低于对照组的22%,差异有统计学意义(P<0.05)。药物的副反应主要为恶心、呕吐,其发生率观察组高于对照组,差异有统计学意义(P<0.05)。结论:卡贝缩宫素联合麦角新碱可降低二次剖宫产产后出血发生率、减少出血量及术中额外使用宫缩剂的概率,预防二次剖宫产产后出血效果确切。
Objective:To observe the effect of carbetocin combined with ergometrine in prevention of postpartum hemorrhage in secondary cesarean section in patients with scar uterus.Methods:A total of 200 cases of pregnant women with cesarean delivery because of scar uterus. In the study,two groups have been divided according to drug use in the operation.The study group was given carbetocin combined with ergometrine(100 cases),while the control group was given oxytocin alone(100 cases).Results:There was no significant difference in 2 h postoperative blood loss between the two groups(P<0.05).The postoperative blood loss at 24 h was significantly lower in the observation group than in the control group,with statistically significant differences.The rate of postpartum hemorrhage was 3% in the observation group,lower than 11% in the control group, and the difference was statistically significant(P<0.05). The rate of additional drug used in the observation group was 5%, significantly lower than 22% in the control group,and the difference was statistically significant(P<0.05). The adverse reactions were mainly nausea and vomiting, the incidence was higher in the observation group than in the control group, and the difference was statistically significant(P<0.05).Conclusion:Carbetocin combined with ergometrine in secondary cesarean section can significantly reduce the incidence of postpartum hemorrhage and blood loss,it is more effective to prevent postpartum hemorrhage in secondary cesarean section and to reduce the additional use of uterotonics during cesarean section.
Objective:To observe the effect of carbetocin combined with ergometrine in prevention of postpartum hemorrhage in secondary cesarean section in patients with scar uterus.Methods:A total of 200 cases of pregnant women with cesarean delivery because of scar uterus. In the study,two groups have been divided according to drug use in the operation.The study group was given carbetocin combined with ergometrine(100 cases),while the control group was given oxytocin alone(100 cases).Results:There was no significant difference in 2 h postoperative blood loss between the two groups(P<0.05).The postoperative blood loss at 24 h was significantly lower in the observation group than in the control group,with statistically significant differences.The rate of postpartum hemorrhage was 3% in the observation group,lower than 11% in the control group, and the difference was statistically significant(P<0.05). The rate of additional drug used in the observation group was 5%, significantly lower than 22% in the control group,and the difference was statistically significant(P<0.05). The adverse reactions were mainly nausea and vomiting, the incidence was higher in the observation group than in the control group, and the difference was statistically significant(P<0.05).Conclusion:Carbetocin combined with ergometrine in secondary cesarean section can significantly reduce the incidence of postpartum hemorrhage and blood loss,it is more effective to prevent postpartum hemorrhage in secondary cesarean section and to reduce the additional use of uterotonics during cesarean section.
引文
[1] Committee on Practice Bulletins-Obstetrics.Practice bulletin No.183:postpartum hemorrhage[J].Obstet Gynecol,2017,130(4):e168-e186.
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[3] Sentilhes L,Goffinet F,Vayssière C,et al.Comparison of postpartum haemo- rrhage guidelines:discrepancies underline our lack of knowledge[J].BJOG,2017,124(5):718-722.
[4] WHO Guidelines Approved by the Guidelines Review Committee.WHO recomm- endations for the prevention and treatment of postpartum haemorrhage[R].Geneva:WHO,2012.
[5] Su LL,Chong YS,Samuel M.Carbetocin for preventing postpartum haemorrhage[J].Cochrane Database Syst Rev,2012,(4):CD005457.
[6] 中华医学会妇产科学分会产科学组.产后出血预防与处理指南(2014)[J].中华妇产科杂志,2014,49(9):641-646.
[7] Gizzo S,Patrelli TS,Gangi SD,et al.Which uterotonic is better to prevent the postpartum hemorrhage?Latest news in terms of clinical efficacy,side effects,and contraindications:a systematic review[J].Reprod Sci,2013,20(9):1011-1019.
[8] Mavrides E,Allard S,Chandraharan E,et al.On behalf of the royal college of physicians:prevention and management of postpartum haemorrhage:Green-top Guideline No.52[J].BJOG,2017,124(5):e106-e149.
[9] 刘兴会,陈锰.全球产后出血指南异同[J].中国实用妇科与产科杂志,2017,33(6):556-559.
[2] 陆彩凤.瘢痕子宫剖宫产术中出血的原因分析及预防措施探讨 [J].中外医学研究,2017,15(28):113-114.
[3] Sentilhes L,Goffinet F,Vayssière C,et al.Comparison of postpartum haemo- rrhage guidelines:discrepancies underline our lack of knowledge[J].BJOG,2017,124(5):718-722.
[4] WHO Guidelines Approved by the Guidelines Review Committee.WHO recomm- endations for the prevention and treatment of postpartum haemorrhage[R].Geneva:WHO,2012.
[5] Su LL,Chong YS,Samuel M.Carbetocin for preventing postpartum haemorrhage[J].Cochrane Database Syst Rev,2012,(4):CD005457.
[6] 中华医学会妇产科学分会产科学组.产后出血预防与处理指南(2014)[J].中华妇产科杂志,2014,49(9):641-646.
[7] Gizzo S,Patrelli TS,Gangi SD,et al.Which uterotonic is better to prevent the postpartum hemorrhage?Latest news in terms of clinical efficacy,side effects,and contraindications:a systematic review[J].Reprod Sci,2013,20(9):1011-1019.
[8] Mavrides E,Allard S,Chandraharan E,et al.On behalf of the royal college of physicians:prevention and management of postpartum haemorrhage:Green-top Guideline No.52[J].BJOG,2017,124(5):e106-e149.
[9] 刘兴会,陈锰.全球产后出血指南异同[J].中国实用妇科与产科杂志,2017,33(6):556-559.