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目的观察卡前列甲酯栓治疗有出血高危因素的产妇剖宫产手术中、术后出血的有效性和安全性。方法对359例有出血高危因素(双胎、羊水过多、巨大儿、前置胎盘、胎盘早剥妊娠合并肝炎)的产妇实行计划性剖宫产术,术中胎儿娩出后随机按宫缩剂使用情况分为3组:缩宫素组102例,缩宫素20单位宫体肌内注射,另20单位加入液体中滴入;缩宫素+卡前列甲酯栓组131例,缩宫素20单位宫体肌内注射,卡前列甲酯栓1mg舌下含服;卡前列甲酯栓组126例,卡前列甲酯栓1mg舌下含服。计算3组术中术后2h出血量及总出血量。结果3组产妇术中术后2h出血量及总出血量分别为缩宫素组(622±319)mL,缩宫素+卡前列甲酯栓组(442±229)mL,卡前列甲酯栓组(449±292)mL,缩宫素组分别与缩宫素+卡前列甲酯栓组和卡前列甲酯栓组比较,差异有统计学意义(P<0.01,P<0.01)缩宫素+卡前列甲酯栓组和卡前列甲酯栓组比较差异无统计学意义(P>0.05)。结论卡前列甲酯栓用于有出血高危因素产妇的剖宫产术,可明显减少术中术后的出血量,与缩宫素联合应用效果较佳。
Objective To observe the effectiveness and safety of card top methyl ester suppository in the treatment of postpartum hemorrhage during cesarean section in women who have the risk of bleeding. Methods 359 cases of bleeding risk factors (twins, polyhydramnios, macrosomia, placenta accreta, placental abortion pregnancy with hepatitis) of the planned cesarean section, random intrauterine fetal delivery after contraceptive Use cases were divided into three groups: oxytocin group of 102 cases, oxytocin 20 units intrauterine injection, the other 20 units added to the liquid instillation; oxytocin + card forefront of methyl ester suppository group of 131 cases, oxytocin 20 units of intrauterine intramuscular injection, card forefront of methyl ester suppository 1mg sublingual; card forefront of methyl ester suppository group of 126 cases, card top column 1mg sublingual sublingual. Three groups were calculated 2h postoperative bleeding and total blood loss. Results The blood loss and total blood loss at 2 hours after operation in the three groups were 622 ± 319 mL for oxytocin group, 442 ± 229 mL for oxytocin + cardinal methylester suppository group, (449 ± 292) mL, oxytocin group and oxytocin + captopril suppository group and captopril suppository group, the difference was statistically significant (P <0.01, P <0.01) oxytocin There was no significant difference between the PCA group and the PCA group (P> 0.05). Conclusions Cardinal methylester suppository is used for cesarean section in maternal women at high risk of hemorrhage, which can significantly reduce the amount of postoperative bleeding and is more effective in combination with oxytocin.