CAJ | 학술논문

目的：探讨卡贝缩宫素对妊娠期高血压疾病妇女剖宫产宫缩乏力性产后出血的预防效果。方法：选择武警后勤学院附属医院产科32周后单胎剖宫产分娩的妊娠期高血压疾病产妇，随机分为2组进行前瞻性随机对照研究。其中治疗组（卡贝缩宫素组）90例，剖宫产时胎儿娩出后卡贝缩宫素100μg宫底肌内注射；对照组（缩宫素组）90例，胎儿娩出后缩宫素100μg宫底肌内注射，2组均同时予缩宫素20 IU持续静脉点滴。记录产后24 h内出血量、血压、胎儿体质量、评分、妊娠妇女心率的变化及药物不良反应。结果：治疗组产后24 h内出血量少于对照组，差异有统计学意义（P＜0.05）。治疗组和对照组产后出血的发生率分别为14.4%和20.0%，差异无统计学意义（P＞0.05）。2组新生儿出生体质量、1分钟Apgar评分、新生儿窒息、羊水性状比较差异无统计学意义（P＞0.05）。治疗组未出现明显恶心呕吐症状。结论：卡贝缩宫素预防妊娠期高血压疾病妇女剖宫产产后出血比单用缩宫素效果更好，无明显不良反应。
목적：탐토잡패축궁소대임신기고혈압질병부녀부궁산궁축핍력성산후출혈적예방효과。방법：선택무경후근학원부속의원산과32주후단태부궁산분면적임신기고혈압질병산부，수궤분위2조진행전첨성수궤대조연구。기중치료조（잡패축궁소조）90례，부궁산시태인면출후잡패축궁소100μg궁저기내주사；대조조（축궁소조）90례，태인면출후축궁소100μg궁저기내주사，2조균동시여축궁소20 IU지속정맥점적。기록산후24 h내출혈량、혈압、태인체질량、평분、임신부녀심솔적변화급약물불량반응。결과：치료조산후24 h내출혈량소우대조조，차이유통계학의의（P＜0.05）。치료조화대조조산후출혈적발생솔분별위14.4%화20.0%，차이무통계학의의（P＞0.05）。2조신생인출생체질량、1분종Apgar평분、신생인질식、양수성상비교차이무통계학의의（P＞0.05）。치료조미출현명현악심구토증상。결론：잡패축궁소예방임신기고혈압질병부녀부궁산산후출혈비단용축궁소효과경호，무명현불량반응。
Objective:To explore carbetocin in the prevention of postpartum hemorrhage (PPH) following cesarean delivery in women with hypertensive disorder complicating pregnancy. Methods:Prospective randomized control study was carried out on single pregnancy with gestation more than 32 weeks following cesarean delivery. All the cases were randomized to receive either carbetocin (treatment group,n=90) or oxytocin (control group,n=90). Following delivery of each baby,20 IU oxytocin was infusion and 100 microgram carbetocin(treatment group) and 100 microgram oxytocin(control group) were given as myometrium injection. 24 h blood volume of postpartum,blood pressure,birth weight,Apgar scores,maternal heart rate and drug adverse reaction were collected. Results:The estimated blood loss within 24 h in treatment group was significantly lower than control group (P<0.05). The incidence postpartum haemorrhage of treatment and control group had no difference (14.4%vs. 20.0%,P>0.05). There was no difference in birth weight,Apgar scores,neonatal asphyxia and amniotic fluid characteristics between the two groups (P>0.05). There was no significant syndrome of nausea and vomiting. Conclusions:Carbetocin makes better effect than common oxytocin on prevention of postpartum haemorrhage cesarean delivery in women with hypertensive disorder complicating pregnancy ,and no adverse complication was found.