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目的观察卡孕栓与缩宫素联合应用在剖宫产中预防产后出血的临床效果。方法选取深圳市横岗人民医院2009年1月～2011年10月之间共600例剖宫产孕妇随机分成A、B、C3组,A组胎儿娩出后立即含服卡孕栓1mg,术后再予卡孕栓1mg塞肛门;B组术后予米索前列腺素0.6mg塞肛门;C组单用缩宫素。3组均在胎儿娩出后立即子宫肌层注射缩宫素20u,同时静滴缩宫素20u。观察3组术中、术后2h、24h出血总量,产后出血率,术后肠鸣音恢复时间及药物的不良反应。结果 A组联合用药较B组和C组在术中、术后2h及24h出血量显著减少,差异有统计学意义(P﹤0.05);发生严重产后出血需要输血者低于B、C组,差异有统计学意义(P﹤0.05);药物不良反应发生率也明显低于B组和C组(P﹤0.05)。结论卡孕栓联合缩宫素在预防剖宫产产后出血效果良好,术中、术后出血率及严重产后出血率低,术后胃肠恢复快,不良反应少,且经济安全,起效快,维持时间长,值得在临床推广应用。
Objective To observe the clinical effect of the combination of carbamazepine and oxytocin in the prevention of postpartum hemorrhage in cesarean section. Methods A total of 600 pregnant women with cesarean section from January 2009 to October 2011 in Shenzhen Henggang People’s Hospital were randomly divided into A, B and C3 groups. Group A fetus received 1mg carbamazepine immediately after delivery. Curet suppository again 1mg plug anus; B group postoperative to misoprostol 0.6mg plug anus; C group with oxytocin alone. 3 groups were injected immediately after the fetus myometrium oxytocin 20u, at the same time intravenous oxytocin 20u. The total intraoperative, postoperative 2h, 24h total bleeding, postpartum hemorrhage, postoperative bowel sounds recovery time and drug adverse reactions were observed. Results The amount of bleeding in group A was significantly lower than that in group B and C at 2h and 24h after operation (P <0.05). The incidence of severe postpartum hemorrhage was lower than that in groups B and C, The difference was statistically significant (P <0.05). The incidence of adverse drug reactions was also significantly lower than that of B and C groups (P <0.05). Conclusions Carprost suppository combined with oxytocin has a good effect in preventing hemorrhage after cesarean section, intraoperative and postoperative bleeding rate and severe postpartum hemorrhage rate, postoperative gastrointestinal rapid recovery, fewer adverse reactions, and economic security, rapid onset , Maintain a long time, it is worth in the clinical application.