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目的 探讨中央性前置胎盘剖宫产术中应用卡前列素氨丁三醇的时机对疗效的影响.方法 将148例中央性前置胎盘产妇按就诊顺序号分为观察组和对照组,每组74例.观察组注射卡前列素氨丁三醇的时间为断脐后,对照组则为胎盘娩出后.比较两组术中和术后24h内出血量、手术时间、胎盘自娩率及不良反应发生率等.结果 观察组的术中出血量明显少于对照组[(503.5±320.8) ml比(672.1 ±409.6) ml],胎盘自娩率明显高于对照组[79.73％(59/74)比54.05％(40/74)],手术时间明显短于对照组[(42± 15) min比(55±16) min],差异均有统计学意义(P＜ 0.05或＜ 0.01);两组术后24h内出血量和不良反应发生率比较差异均无统计学意义(P＞0.05).结论 中央性前置胎盘产妇行剖宫产术时,于断脐后即将卡前列素氨丁三醇注射入宫体可提高胎盘自娩率,缩短手术时间,减少术中出血量,值得临床借鉴和推广.“,”Objective To explore the curative effect of the different utilized timing of romethamine in cesarean section with central placenta previa.Methods All of 148 patients with central placenta previa were divided into observation group (74 patients) and control group (74 patients) according to the serial number.The patients in observation group were given romethamine after breaking off umbilical core,the patients in control group were given romethamine after placental expulsion.The intraoperative blood loss,postoperative 24 h blood loss,operation time,rate of automatic placental expulsion and adverse reaction were compared.Results The intraoperative blood loss in observation group was less than that in control group[(503.5 ± 320.8) ml vs.(672.1 ± 409.6) ml],the rate of automatic placental expulsion was higher than that in control group [79.73％ (59/74) vs.54.05％ (40/74)],the operation time was less than that in control group [(42 ± 15) min vs.(55 ± 16) min],there was significant difference (P ＜0.05 or ＜0.01).The postoperative 24 h blood loss and the adverse reaction between two groups had no significant difference (P ＞ 0.05).Conclusions In cesarean section with central placenta previa,given romethamine after breaking off umbilical core can improve the rate of automatic placental expulsion,shorten operation time,decrease intraoperative blood loss.It is worthy of spreading.