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目的观察缩宫素联合卡孕栓不同给药时间防治高危产妇剖宫产产后出血的临床效果。方法将309例有产后出血高危因素,计划行剖宫产的产妇随机分为A组、B组和C组,每组各103例。A组采用缩宫素预防性治疗,B组采用缩宫素+卡孕栓(娩出前)预防性治疗,C组采用缩宫素+卡孕栓(娩出后)预防性治疗。比较3组第三产程时间,术中、术后2 h、术后24 h出血量,不同危险因素出血情况以及产后出血发生率。结果第三产程时间:B组部分性>边缘性(P<0.05)。胎盘位于前壁较后壁更易出血,差异有统计学意义(P<0.05)。结论采用缩宫素+卡孕栓(娩出前)预防性治疗剖宫产产后出血的临床效果优于单用缩宫素及缩宫素+卡孕栓(娩出后)预防性治疗,可显著缩短第三产程时间,减少不同高危产妇术中以及术后出血量,降低产后出血发生率。
Objective To observe the clinical effect of oxytocin combined with carbamazepine on different administration time to prevent high-risk maternal cesarean section postpartum hemorrhage. Methods 309 cases of risk factors for postpartum hemorrhage, planned cesarean section were randomly divided into group A, group B and group C, with 103 cases in each group. Group A was treated with oxytocin prophylaxis, group B was treated with oxytocin + carbamazepine (before delivery), and group C was treated prophylactically with oxytocin + carbamazepine (after delivery). The duration of the third stage of labor, intraoperative and postoperative 2 h, the amount of hemorrhage after 24 h, the risk of bleeding and the incidence of postpartum hemorrhage were compared among the three groups. Results The third stage of labor time: B group partial> marginal (P <0.05). The placenta was more prone to hemorrhage than the posterior wall in the anterior wall, the difference was statistically significant (P <0.05). Conclusions The prophylactic treatment of bleeding after cesarean section with oxytocin + carbamazepine (before delivery) is superior to the prophylactic treatment with oxytocin alone and oxytocin plus carbamazepine (after delivery), which can be significantly shortened The third stage of labor time, reduce the high risk of maternal surgery and postoperative bleeding, reduce the incidence of postpartum hemorrhage.