CAJ | 학술논문

目的：预防性宫体注射卡前列素氨丁三醇在具有产后出血高危因素孕妇剖宫产术中的应用效果观察。方法选取2013年1月~2014年5月本院产科待产并且合并有产后出血高危因素的116例孕妇随机分两为组，对照组(n=59)给予产后出血的常规防治措施，观察组(n=57)加用卡前列素氨丁三醇宫颈或宫体注射，对两组产妇产后出血发生率、产后出血量及药物不良反应发生情况进行综合比较。结果观察组产后出血率为12.28%，对照组为27.12%，两组产妇产后出血发生率比较，差异有统计学意义(P<0.05)；观察组产妇产后2、24 h的平均出血量分别为(209.5±57.0)、(305.8±70.5)ml，对照组分别为(314.2±69.1)、(370.1±76.4)ml，观察组均明显少于对照组(P<0.01)；观察组出现恶心、呕吐等胃肠道反应7例(12.28%)，寒战1例(1.75%)，发热1例(1.75%)，面部潮红1例(1.75%)，上述不良反应均自行缓解，对照组患者无明显药物不良反应情况发生，两组无一例患者因严重药物不良反应而停止治疗。结论针对有产后出血高危因素的临床孕产妇，预防性宫颈或宫体注射卡前列素氨丁三醇能明显降低产后出血率及出血量，安全性高，值得临床推广应用。
목적：예방성궁체주사잡전렬소안정삼순재구유산후출혈고위인소잉부부궁산술중적응용효과관찰。방법선취2013년1월~2014년5월본원산과대산병차합병유산후출혈고위인소적116례잉부수궤분량위조，대조조(n=59)급여산후출혈적상규방치조시，관찰조(n=57)가용잡전렬소안정삼순궁경혹궁체주사，대량조산부산후출혈발생솔、산후출혈량급약물불량반응발생정황진행종합비교。결과관찰조산후출혈솔위12.28%，대조조위27.12%，량조산부산후출혈발생솔비교，차이유통계학의의(P<0.05)；관찰조산부산후2、24 h적평균출혈량분별위(209.5±57.0)、(305.8±70.5)ml，대조조분별위(314.2±69.1)、(370.1±76.4)ml，관찰조균명현소우대조조(P<0.01)；관찰조출현악심、구토등위장도반응7례(12.28%)，한전1례(1.75%)，발열1례(1.75%)，면부조홍1례(1.75%)，상술불량반응균자행완해，대조조환자무명현약물불량반응정황발생，량조무일례환자인엄중약물불량반응이정지치료。결론침대유산후출혈고위인소적림상잉산부，예방성궁경혹궁체주사잡전렬소안정삼순능명현강저산후출혈솔급출혈량，안전성고，치득림상추엄응용。
Objective To observe the application effect of preventive injection of romethamine into the uterine body of the pregnant women with high risk factors of postpartum hemorrhage in cesarean section. Methods 116 cases of preg-nant women with high risk factors of postpartum hemorrhage in cesarean section to produce in our hospital from Jan-uary 2013 to May 2014 were selected and randomly divided into two groups.The pregnant women (n=59) in control group were given the conventional measures and treatment of postpartum hemorrhage while the pregnant women (n=57) in observation group were treated with uterine body injection of romethamine based on the treatment of control group. The rate of hemorrhage,amount of postpartum hemorrhage and the incidence of adverse drug reactions of patients be-tween two groups were comprehensively compared. Results The rate of postpartum hemorrhage in observation group ac-counted for 12.28% while that in control group accounted for 27.12%.The incidence of postpartum hemorrhage of two groups had significant difference (P<0.05);The average amount of blood loss of the patients 2,24 h in observation group were[(209.5±57.0),(305.8±70.5) ml] while that in control group were(314.2±69.1) ml and (370.1±76.4) ml,The average amount of blood loss of the patients in observation group was significantly less than that in control group(P<0.01).7 cas-es(12.28%) in observation group had nausea,vomiting and other gastrointestinal reactions,1 cases had chills (1.75%),1 cases had a fever (1.75%) and 1 cases had facial flushing (1.75%).The adverse reactions above could be relieved by themselves.There was no obvious adverse drug reaction in control group.There were not any patient who stopped receiv-ing the treatment between two groups because of severe adverse reaction. Conclusion For the pregnant women with high risk factors of postpartum hemorrhage,the preventive uterine body injection of romethamine can significantly re-duce the rate of postpartum hemorrhage and the amount of bleeding,and the safety of the treatment is high.It is worthy of clinical application.