欣母沛防治乙型肝炎产妇剖宫产产后出血的临床疗效观察  

The efficacy and security of Hemabate in prevention and cure of postpartum hemorrhage after cesarean section on parturients with hepatitis B

作　　者：余敏敏[1] 吴凯华[1] 季莹[1] 鞠丽丽[1] 

机构地区：[1]东南大学医学院附属南京市第二医院妇产科,江苏南京210003

出　　处：《南京医科大学学报（自然科学版）》2009年第11期1595-1598,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:观察欣母沛对防治乙型肝炎产妇剖宫产产后出血的效果和安全性。方法:选择肝功异常但凝血功能正常的乙型肝炎剖宫产产妇300例,随机分为欣母沛组、缩宫素组、联合组(欣母沛加缩宫素),各100例。3组均在胎儿娩出后立即宫体注射药物。比较各组产后2h内及产后24h内的出血量及产后出血率、治疗总有效率。观察各组产妇用药后的不良反应及丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血清总胆红素(TB)变化。结果:欣母沛组及联合组的产后出血发生率分别为22%、20%,明显低于缩宫素组的54%(P<0.01)。两组产后2h、24h平均出血量分别为(271.54±73.96)ml、(360.97±90.12)ml,也明显少于缩宫素组的(368.38±125.41)ml、(486.84±144.35)ml,差异有显著性(P<0.01)。欣母沛组及联合组治疗总有效率96%,明显高于缩宫素组的87%(P<0.05)。用药后缩宫素组ALT、AST、TB较欣母沛组、联合组均有不同程度升高,且ALT、AST的变化有显著差异(P<0.05)。欣母沛组与联合组比较,ALT、AST、TB差异无显著性(P>0.05)。部分产妇出现恶心、呕吐、腹泻、高血压等不良反应,一般均可自行恢复。结论:欣母沛对防治乙型肝炎产妇剖宫产宫缩乏力性产后出血的效果显著,不良反应小,且对肝功能几乎无影响,安全性良好。Objective：To observe the efficacy and security of Hemabate in prevention and cure of postpartum hemorrhage after cesarean section （CS） on parturient with hepatitis B. Methods： Three hundred cases of parturients with hepatitis B accepted cesarean section,whose liver function were abnormal but blood clotting function normal,were divided into 3 groups randomly,and named Hemabate group, Oxytocin group and Combined group respectively. They were all medicated at the moment after childbirth. The postpartum hemorrhage volumes in 2 hours and 24 hours,the ratios of postpartum hemorrhage and the total effective rates were compared among the 3 groups. The advise reactions and the changes of liver function including alanine aminotransferase（ALT）,aspartate aminotransferase （AST）,totle bilirubin（TB） after medication were observed. Results：The ratios of postpartum hemorrhage in uterine inertia of Hemabate group and Combined group were 22% and 20%,much lower than that of Oxytocin group （54%）（P 〈 0.01 ）. The postpartum hemorrhage in Hemabate group volumes in 2 hours and 24 hours were （271.54±73.96）ml and （360.97±90.12）ml,which were both much lower than those in Oxytocin group （P 〈 0.01 ）. The total effective rates of Hemabate group and combined group were 96% ,which was higher than that of Oxytocin group （87%）. The levels of ALT,AST,TB in Oxytocin group were higher than Hemabate group and combined group in different extent and there were significant differences in ALT and AST（P 〈 0.05） ,but there was no significant differentce in ALT,AST and TB between Hemabate group and Combined group（P 〉 0.05）. Some patients suffered from nausea,vomiting, diarrhea,high blood pressure, etc., may almost recover without any disposal. Conclusion ：The Hemabate has notable efficacy and slide adverse reaction in prevention and cure of postpartum hemorrhage after CS because of weak uterine contraction on parturient with hepatitis B. Further more,it had nearly no influence on liver functio

关 键 词：欣母沛 剖宫产 宫缩乏力 产后出血 肝功能 

分 类 号：R714.46[医药卫生—妇产科学]