摘要
目的比较麦角新碱联合卡贝缩宫素与单用缩宫素预防剖宫产产后出血的效果。方法采用真实世界研究方法,回顾性分析四川大学华西第二医院2017年1—12月收治的择期剖宫产孕妇424例。根据胎儿娩出后用药情况分为两组:给予麦角新碱联合卡贝缩宫素为研究组(208例),单用缩宫素为对照组(216例)。结果研究组术中额外用药率为2.4%,明显低于对照组22.2%,差异有统计学意义(P<0.05)。研究组手术前后血红蛋白及红细胞压积分别为(126.9±9.9)g/L、(123.1±10.9)g/L及0.38±0.03、0.37±0.03,对照组分别为(126.6±12.1)g/L、(123.9±14.3)g/L及0.38±0.03、0.37±0.04,两组比较差异均无统计学意义(P>0.05)。两组孕产妇失血量及按照单一合并症及并发症(妊娠期肝内胆汁淤积症、胎膜早破、妊娠期糖尿病、瘢痕子宫、胎盘粘连)估计失血量,两组比较差异均无统计学意义(P>0.05);而严重产后出血率(出血量大于1000m L)研究组为1.4%,对照组为3.2%,两组之间的差异有统计学意义(P<0.05)。结论麦角新碱联合卡贝缩宫素预防剖宫产严重产后出血及减少术中额外使用宫缩剂的效果较显著。
Objective To compare the effect of ergometrine combined with carbetocin and oxycontin alone in prevention of postpartum hemorrhage in cesarean section. Methods By real world research method,retrospectively analyse the424 cases of pregnant women with elective cesarean section admitted to Sichuan University West China Second University Hospital from January 2017 to December 2017.In the study,two groups have been divided according to drug use after delivery.The study group was given ergometrine combined with carbetocin（208 cases）,while the control group was given oxytocin alone（216 cases）.Results The rate of additional uterotonics used in the study group was 2.4%,which was significantly lower than that in the control group,which was 22.2%. The difference was statistically significant（P〈0.05）.The hemoglobin and hematocrit of the study group before and after the operation were（126.9±9.9）g/L,（123.1±10.9）g/L,0.38±0.03 and 0.37±0.03,respectively,and in the control group,the results were（126.6±12.1）g/L,（123.9±14.3）g/L,0.38±0.03 and 0.37±0.04,respectively.There was no significant difference between the two groups（P〉0.05）.In terms of the total maternal blood loss and the blood loss according to a single complication,such as intrahepatic cholestasis of pregnancy,premature rupture of membrane,gestational diabetes mellitus,scarred uterus and placental adhesion,there was no significant difference between the two groups（P〉0.05）.The rate of severe postpartum hemorrhage（greater than1000 m L）was 1.4% in the study group and 3.2% in the control group. The difference between the two groups was statistically significant（P〈0.05）.Conclusion It is more effective to use ergometrine combined with carbetocin to prevent severe postpartum hemorrhage and to reduce the additional use of uterotonics during cesarean section.
作者
卫蔷
张力
吴琳
陈锰
刘兴会
WEI Qiang;ZHANG Li;WU Lin;CHEN Meng;LIU Xing-hui.(West China Second University Hospital of Sichuan University, Key Laboratory of Birth Defects and Related to Women＇ s Diseases, Ministry of Education, Chengdu 610041, China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2018年第6期640-644,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家重点研发计划"生殖健康及重大出生缺陷防控研究"重点专项(2016YFC1000406)
