Prophylactic effect of different prostaglandins combined with oxytocin on postpartum hemorrhage after repeated cesarean section in women with scar uterus
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摘要: 目的 探讨不同前列腺素类药物联合缩宫素对瘢痕子宫产妇再次剖宫产产后出血的预防效果。 方法 将90例瘢痕子宫产妇随机分为A组和B组,每组45例。A组给予阴道填塞卡前列甲酯栓, B组给予卡前列素氨丁三醇注射液。观察术中2 h和产后2、24 h出血量,并比较2组产后出血、输血率和产后不良反应发生情况。 结果 产后2 h, 2组活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)和纤维蛋白原(Fib)水平均低于术前,且B组APTT、TT、Fib水平均低于A组,差异有统计学意义(P<0.05)。给药后, B组子宫收缩持续时间长于A组,子宫底下降速度快于A组,差异有统计学意义(P<0.05)。B组产后2、24 h出血量均少于A组,差异有统计学意义(P<0.05)。2组产后不良反应发生率比较,差异无统计学意义(P>0.05)。 结论 卡前列甲酯栓和卡前列素氨丁三醇对瘢痕子宫产妇再次剖宫产产后出血的预防效果相近,但卡前列素氨丁三醇在促进子宫收缩、改善凝血功能和减少产后出血量方面效果更佳。Abstract: Objective To explore the preventive effect of different prostaglandins combined with oxytocin on postpartum hemorrhage after repeated cesarean section in women with scar uterus. Methods A total of 90 pregnant women with scar uterus were randomly divided into group A and group B, with 45 cases in each group. Group A was given vaginal cramping with carboprost methylate suppositories, group B was given carboprost tromethamine injection. Intraoperative blood loss at 2 h and at 2, 24 h after delivery were observed, and the incidence of postpartum hemorrhage, blood transfusion rate and postpartum adverse reactions were compared between the two groups. Results After 2 h postpartum, the activated partial thromboplastin time(APTT), plasma thrombin time(TT)and fibrinogen(Fib)levels in both groups were significantly lower than those before surgery, and the levels of APTT, TT and Fib in group B were significantly lower than those in group A(P<0.05). After drug administration, the duration of uterine contraction in group B was significantly longer than that in group A, and the speed of uterine floor decline was significantly faster than that in group A(P<0.05). The blood loss in group B at 2, 24 h after delivery was significantly less than those in group A(P<0.05). There was no statistically significant difference in the incidence of postpartum adverse reactions between the two groups(P>0.05). Conclusion Carboprost methylate suppositories has similar effect compared with carboprost tromethamine injection in the prevention of postpartum hemorrhage after cesarean section in women with scar uterus. But carboprost tromethamine injection is more effective in promoting uterine contractions, improving blood clotting and reducing postpartum blood loss.
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李宏田, 刘建蒙, 刘菊芬, 等. 2008—2014中国剖宫产率变化趋势和地区差异研究[J]. 中华预防医学杂志, 2017, 51(3): 242. 王建英, 陈瑶, 陈芳, 等. 高危妊娠孕产妇相关危险因素分析[J]. 中国实用护理杂志, 2019, 35(13): 961-964. 许占英. 瘢痕子宫再次妊娠采取阴道分娩的成功率与安全性[J]. 中国药物与临床, 2019, 19(12): 2022-2023. 谢幸, 苟文丽. 妇产科学[M]. 8版. 北京: 人民卫生出版社, 2013: 211-213. 聂志扬, 胡俊华, 宫济武. 英国皇家妇产科医师学院《产科输血指南》(第2版)解读[J]. 中华围产医学杂志, 2016, 19(8): 565-567. MASWIME S, BUCHMANN E. A systematic review of maternal near miss and mortality due to postpartum hemorrhage[J]. Int J Gynecol Obstet, 2017, 137(1): 1-7.
陈锰, 长力, 杨帆, 等. 剖宫产术后瘢痕子宫孕妇的子宫下段厚度与再次妊娠后子宫破裂风险的研究进展[J]. 中华妇产科杂志, 2017, 52(6): 425-428. BRUEY N, BEUCHER G, PESTOUR D, et al. Caesarean section at full dilatation: What are the risks to fear for the mother and child[J]. Gynecol Obstet Fertil Senol, 2017, 45(3): 137-145.
张敏. 卡贝缩宫素与卡前列腺素氨丁三醇防治瘢痕子宫剖宫产后出血的临床效果比较[J]. 中国计划生育学杂志, 2017, 25(11): 779-780. 许珍. 卡前列甲酯栓含服联合米索前列醇塞肛在预防瘢痕子宫剖宫产出血中的应用[J]. 医学临床研究, 2017, 34(12): 2441-2443. 石巍. 米索前列醇与卡前列素氨丁三醇预防剖宫产产后出血的效果比较[J]. 安徽医药, 2017, 21(2): 311-314. 蒋惠彬. 预见性风险管理配合宫缩素预防产后出血的效果[J]. 血栓与止血学, 2018, 24(6): 1055-1057 , 1061.
张婧, 张忠明. 剖宫产术后应用宫体注射卡前列素氨丁三醇对产后出血预防效果及凝血功能的影响[J]. 河北医科大学学报, 2019, 40(1): 102-105. 何雪芬, 朱雪琼. 卡前列素氨丁三醇对预防剖宫产产后出血的疗效及对凝血功能、血流动力学的影响[J]. 数理医药学杂志, 2018, 31(5): 718-721. 陆建平, 李天涛. 高危剖宫产孕妇给予欣母沛防治产后出血及不良事件的临床效果[J]. 中国妇幼保健, 2016, 31(18): 3717-3719. 黄华, 杨建碧. 前列腺素类药物联合缩宫素预防高危妊娠剖宫产产后出血效果观察[J]. 蚌埠医学院学报, 2019, 44(5): 597-599 , 603.
邰莹, 刘海霞, 陈必良. 不同药物联合缩宫素对预防剖宫产高危产妇产后出血的效果及对凝血功能的影响[J]. 解放军医药杂志, 2018, 30(7): 84-87.
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