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目的:观察卡贝缩宫素预防性治疗宫缩乏力性产后出血60例的效果。方法:选择120例剖宫产产妇,随机分为治疗组和对照组各60例。两组产妇统一采用下腹横切口长约12~15 cm,刺破羊膜囊,吸净前羊水,娩出胎儿,将后羊水吸净,用子宫钳钳夹子宫切缘,并记录所吸羊水量,用吸收线连续缝合子宫肌全层,连续缝合膀胱腹膜反折,逐层关腹。对照组采用米索前列醇治疗,于胎儿娩出后给予米索前列醇400 pg口服,同时给催产素20 U子宫肌注射。治疗组在对照组治疗的基础上,在胎儿分娩后,对患者直接静脉注射卡贝缩宫素100μg。结果:治疗组和对照组分别为98.3%和88.3%,治疗组总有效率和显效率均优于对照组,差异均有统计学意义;2 h及24 h出血量比较,治疗组均优于对照组(P<0.05)。治疗组治疗后收缩压和舒张压分别为(109.7±11.3)mmHg、(75.1±9.7)mmHg,对照组治疗后分别为(111.2±13.8)mmHg、(76.2±9.8)mmHg。两组血压治疗前后及组间比较,差异均无统计学意义(P>0.05),但HB下降值比较,差异有统计学意义(P<0.05)。且两组均无明显不良反应。结论:预防性使用卡贝缩宫素可明显加强子宫收缩,对减少产后出血、降低HB值等指标具有重大意义,且卡贝缩宫素治疗宫缩乏力性产后出血也并无明显不良反应,值得临床推广使用。
Objective: To observe the effect of carbetocin in the prophylactic treatment of 60 cases of uterine inertia postpartum hemorrhage. Methods: 120 cases of cesarean section were selected and randomly divided into treatment group and control group of 60 cases. The two groups of maternal uniform use of abdominal transverse incision length of about 12 ~ 15 cm, punctured the amniotic sac, net absorption of amniotic fluid, the fetus was released, the amniotic fluid after sucking net, with uterine forceps clamp uterine incision, and record the amount of amniotic fluid absorbed, With absorption line continuous suture the uterine muscle full-thickness, continuous suture peritoneal buckling of the bladder, layer by layer. The control group was treated with misoprostol, 400 pg of misoprostol was administered orally after delivery of the fetus, and 20 U of uterine muscle was injected with oxytocin. The treatment group in the control group based on the treatment, in the fetus after childbirth, direct intravenous injection of carbetocin 100μg. Results: The treatment group and the control group were 98.3% and 88.3% respectively. The total effective rate and markedly effective rate in the treatment group were better than those in the control group, and the differences were statistically significant. The bleeding volume in 2 h and 24 h was better than that in the control group Control group (P <0.05). The systolic blood pressure and diastolic blood pressure in the treatment group were (109.7 ± 11.3) mmHg and (75.1 ± 9.7) mmHg respectively, and were (111.2 ± 13.8) mmHg and (76.2 ± 9.8) mmHg in the control group respectively. There was no significant difference in blood pressure before and after treatment and between two groups (P> 0.05), but there was significant difference between HB values (P <0.05). And no significant adverse reactions in both groups. Conclusion: The prophylactic use of carbetocin can significantly enhance uterine contractions, reduce the postpartum hemorrhage, reduce the value of HB and other indicators of great significance, and carbetocin treatment of uterine inertia postpartum hemorrhage and no significant adverse reactions, It is worth to promote clinical use.