中华产科急救电子杂志
中華產科急救電子雜誌
중화산과급구전자잡지
Chinese Journal of Obstetric Emergency
2014年
2期
127-131
,共5页
王晓怡%王子莲%钟梅%牛建民%何平%王晨虹%黄素然%隗伏冰%熊小英%陈敦金
王曉怡%王子蓮%鐘梅%牛建民%何平%王晨虹%黃素然%隗伏冰%熊小英%陳敦金
왕효이%왕자련%종매%우건민%하평%왕신홍%황소연%외복빙%웅소영%진돈금
卡前列素氨丁三醇%剖宫产术%产后出血%治疗结果
卡前列素氨丁三醇%剖宮產術%產後齣血%治療結果
잡전렬소안정삼순%부궁산술%산후출혈%치료결과
Carboprost Tromethamine%Cesarean section%Postpartum hemorrhage%Treatment outcome
目的：评估国产卡前列素氨丁三醇（商品名：安列克）防治高危产妇剖宫产术中及术后出血的有效性和安全性。方法将2011年3月至12月就诊于广东9家医院具有出血高危因素行剖宫产术的产妇360例患者，按胎儿娩出后宫体注射子宫收缩药物的不同分成3组：A组（注射缩宫素），B组（注射缩宫素和卡前列素氨丁三醇组），C组（注射卡前列素氨丁三醇），每组各120例，分析比较各组术中、术后2h及术后24h出血量及药物副作用的情况。结果 B组术中、术后2h、术后24 h出血量[分别为（331.4±209.7）ml，（421.8±239.2）ml，（593.6±242.3）ml]明显低于A组[分别为（417.3±235.2）ml，（613.4±301.9）ml，（685.7±296.1）ml]，差异均有统计学意义（P＜0.05）；C组[分别为（352.5±253.4）ml，（479.4±201.7）ml，（607.1±246.6）ml]也明显低于A组，差异均有统计学意义（P＜0.05）；而B组与C组比较，差异均无统计学意义（P＞0.05）。360例产妇，发生产后出血有42例，产后出血发生率为11.7％。 A组产后出血的发生率（18.3％，22/120）明显高于B组（7.5％，9/120）和C组（9.2％，11/120），礸2＝6.145、3.596，差异均有统计学意义（P＜0.05）；B组和C组治疗性宫缩剂的应用百分率[（分别为（11.1％，1/9）、（18.2％，2/11）明显少于A组（68.2％，15/22），礸2＝10.190、8.164，差异均有统计学意义（P＜0.05）。360例使用宫缩剂的患者中，有27例发生1种或以上的副作用，发生率为7.5％。 B 组副作用的发生率（12.5％，15/120）高于 A 组（3.3％，4/120）和C组（6.7％，8/120），礸2＝12.451、9.254，差异均有统计学意义（P＜0.05）；但各种副反应的发生率在3组患者间的比较差异均无统计学意义（ P＞0.05）。结论卡前列素氨丁三醇预防和治疗高危产妇剖宫产术中及术后出血安全有效，但要密切注意药物副作用。
目的：評估國產卡前列素氨丁三醇（商品名：安列剋）防治高危產婦剖宮產術中及術後齣血的有效性和安全性。方法將2011年3月至12月就診于廣東9傢醫院具有齣血高危因素行剖宮產術的產婦360例患者，按胎兒娩齣後宮體註射子宮收縮藥物的不同分成3組：A組（註射縮宮素），B組（註射縮宮素和卡前列素氨丁三醇組），C組（註射卡前列素氨丁三醇），每組各120例，分析比較各組術中、術後2h及術後24h齣血量及藥物副作用的情況。結果 B組術中、術後2h、術後24 h齣血量[分彆為（331.4±209.7）ml，（421.8±239.2）ml，（593.6±242.3）ml]明顯低于A組[分彆為（417.3±235.2）ml，（613.4±301.9）ml，（685.7±296.1）ml]，差異均有統計學意義（P＜0.05）；C組[分彆為（352.5±253.4）ml，（479.4±201.7）ml，（607.1±246.6）ml]也明顯低于A組，差異均有統計學意義（P＜0.05）；而B組與C組比較，差異均無統計學意義（P＞0.05）。360例產婦，髮生產後齣血有42例，產後齣血髮生率為11.7％。 A組產後齣血的髮生率（18.3％，22/120）明顯高于B組（7.5％，9/120）和C組（9.2％，11/120），礸2＝6.145、3.596，差異均有統計學意義（P＜0.05）；B組和C組治療性宮縮劑的應用百分率[（分彆為（11.1％，1/9）、（18.2％，2/11）明顯少于A組（68.2％，15/22），礸2＝10.190、8.164，差異均有統計學意義（P＜0.05）。360例使用宮縮劑的患者中，有27例髮生1種或以上的副作用，髮生率為7.5％。 B 組副作用的髮生率（12.5％，15/120）高于 A 組（3.3％，4/120）和C組（6.7％，8/120），礸2＝12.451、9.254，差異均有統計學意義（P＜0.05）；但各種副反應的髮生率在3組患者間的比較差異均無統計學意義（ P＞0.05）。結論卡前列素氨丁三醇預防和治療高危產婦剖宮產術中及術後齣血安全有效，但要密切註意藥物副作用。
목적：평고국산잡전렬소안정삼순（상품명：안렬극）방치고위산부부궁산술중급술후출혈적유효성화안전성。방법장2011년3월지12월취진우엄동9가의원구유출혈고위인소행부궁산술적산부360례환자，안태인면출후궁체주사자궁수축약물적불동분성3조：A조（주사축궁소），B조（주사축궁소화잡전렬소안정삼순조），C조（주사잡전렬소안정삼순），매조각120례，분석비교각조술중、술후2h급술후24h출혈량급약물부작용적정황。결과 B조술중、술후2h、술후24 h출혈량[분별위（331.4±209.7）ml，（421.8±239.2）ml，（593.6±242.3）ml]명현저우A조[분별위（417.3±235.2）ml，（613.4±301.9）ml，（685.7±296.1）ml]，차이균유통계학의의（P＜0.05）；C조[분별위（352.5±253.4）ml，（479.4±201.7）ml，（607.1±246.6）ml]야명현저우A조，차이균유통계학의의（P＜0.05）；이B조여C조비교，차이균무통계학의의（P＞0.05）。360례산부，발생산후출혈유42례，산후출혈발생솔위11.7％。 A조산후출혈적발생솔（18.3％，22/120）명현고우B조（7.5％，9/120）화C조（9.2％，11/120），찰2＝6.145、3.596，차이균유통계학의의（P＜0.05）；B조화C조치료성궁축제적응용백분솔[（분별위（11.1％，1/9）、（18.2％，2/11）명현소우A조（68.2％，15/22），찰2＝10.190、8.164，차이균유통계학의의（P＜0.05）。360례사용궁축제적환자중，유27례발생1충혹이상적부작용，발생솔위7.5％。 B 조부작용적발생솔（12.5％，15/120）고우 A 조（3.3％，4/120）화C조（6.7％，8/120），찰2＝12.451、9.254，차이균유통계학의의（P＜0.05）；단각충부반응적발생솔재3조환자간적비교차이균무통계학의의（ P＞0.05）。결론잡전렬소안정삼순예방화치료고위산부부궁산술중급술후출혈안전유효，단요밀절주의약물부작용。
Objective To evaluate the curative effect and safety of domestic Carboprost Tromethamine ( trade name:An Lie ke ) on preventing intraoperative hemorrhage and postoperative hemorrhage of high risk pregnant women with cesarean section.Methods Three hundred and sixty pregnant women, who were admitted into 9 hospitals of Guangdong province from March to December 2011, had cesarean section due to bleeding high risk factors.According to the oxytocic drugs injected in the uterine body after delivery, 360 pregnant women were divided into 3 groups: group A ( only injected oxytocin) , group B ( injected oxytocin plus Carboprost Tromethamine ) and group C ( only injected Carboprost Tromethamine) .There were 120 patients in each group.The amount of bleeding was observed during operation, 2 hours after operation and 24 hours after operation, respectively.The amount of bleeding in each observation time and oxytocic drug side effects of the 3 groups were compared.Results In group B, the amount of bleeding were (331.4 ±209.7)ml, (421.8 ±239.2)ml and (593.6 ±242.3)ml during operation, 2 hours after operation and 24 hours after operation, respectively, which were significantly less than those in group A[(417.3 ±235.2)ml, (613.4 ±301.9)ml and (685.7 ±296.1)ml] (P<0.05). In group C, the amount of bleeding were (352.5 ±253.4)ml, (479.4 ±201.7)ml and (607.1 ±246.6)ml during operation, 2 hours after operation and 24 hours after operation, respectively, which were also significantly less than those in group A (P<0.05).But there was no significant difference between group B and group C (P>0.05).Totally, 42 cases of 360 cases were postpartum hemorrhage, which incidence rate was 11.7%.The incidence rate of postpartum hemorrhage in group A ( 18.3%, 22/120 ) was significantly higher than that in group B(7.5%,9/120) and group C(9.2%,11/120), (χ2=6.145 and 3.596, P value<0.05).The usage rate of extra oxytocic drugs was 11.1%(1/9) in group B and 18.2%(2/11) in group C, which were significantly lower than that in group A (68.2%, 15/22), (χ2=10.190 and 8.164, P value<0.05).Among the 360 patients, 27 patients had 1 or more adverse reactions; the incidence rate was 7.5%.The incidence rate of adverse reaction in group B (12.5%, 15/120) was higher than those in group A (3.3%, 4/120) and in group C(6.7%, 8/120), (χ2=12.451 and 9.254, P value<0.05).But the incidence rate of each side reaction had no significant difference in the 3 groups ( P value>0.05) .Conclusions Domestic Carboprost Tromethamine was effective and safe for high risk pregnant women with cesarean section to prevent intraoperative hemorrhage and postoperative hemorrhage. But the side effects need to be closely observed.
