卡前列素氨丁三醇不同给药方式治疗难治性产后出血的临床疗效及安全性  

Clinical efficacy and safety of carboprost tromethamine in the treatment of intractable postpartum hemorrhage with different ways of administration

作　　者：杨秀录 金伟敏 周静 杨松玉 虞希祥[4] YANG Xiulu;JIN Weimin;ZHOU Jing;YANG Songyu;YU Xixiang(Department of Ultrasonic,the Third Hospital of Wenzhou Medical University,Ruian 325200,China;Department of Paediatrics,the Third Hospital of Wenzhou Medical University,Ruian 325200,China;Department of Gynaecology and Obstetrics,the Third Hospital of Wenzhou Medical University,Ruian 325200,China;Department of Interventional Vascular Surgery,the Third Affiliated Clinic Medical College of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第三医院超声室,瑞安325200 [2]温州医科大学附属第三医院儿科,瑞安325200 [3]温州医科大学附属第三医院妇产科,瑞安325200 [4]温州医科大学附属温州市第三临床学院介入血管外科,温州325000

出　　处：《中国临床药学杂志》2019年第2期93-96,共4页Chinese Journal of Clinical Pharmacy

摘　　要：目的探讨卡前列素氨丁三醇不同给药方式治疗难治性产后出血的临床疗效及安全性。方法选取2015年6月至2017年6月收治的80例难治性产后出血患者,采用数字随机分配原则将其分为对照组和研究组,每组40例。2组产妇均在胎儿娩出后缓慢静脉推注卡贝缩宫素注射剂100μg,对照组产妇在此基础上手臂三角肌肌内注射卡前列素氨丁三醇250μg,研究组产妇在宫颈注射卡前列素氨丁三醇250μg。比较2组产妇产后不同时间点出血量、围术期指标、治疗总有效率以及不良反应发生情况,同时于术后2周对剖宫产产妇行超声检查,了解子宫恢复情况。结果治疗后研究组产妇的临床治疗总有效率为95.0%,明显高于对照组产妇的80.0%(P<0.05);研究组产妇的手术时间、下床活动时间和住院时间等围术期指标均显着短于对照组产妇,并且研究组产妇术后2 h和术后24 h出血量均明显低于对照组产妇,差异有统计学意义(P<0.05)。研究组产妇恶心、呕吐和腹泻等并发症发生率与对照组产妇相比差异无明显统计学意义(P>0.05)。超声检查结果示,2组剖宫产产妇子宫复旧均良好。结论相较于手臂三角肌肌内注射方式而言,宫颈注射卡前列素氨丁三醇能够明显减少产后出血,促进产妇预后,疗效确切且安全性较高,值得临床推广应用。AIM To explore the clinical efficacy and safety of carboprost tromethamine in the treatment of intractable postpartum hemorrhage( IPH) with different ways of administration. METHODS Totally 80 cases of IPH treated in our hospital from June 2015 to June 2017 were selected and randomly divided into the control group and the experimental group according to the principle of digital random distribution,40 cases in each group. The 2 groups received slow intravenous injection of carbetocin injection 100 μg after the birth of fetus ,the control group received arm deltoid intramuscular injection of carboprost tromethamine 250 μg,and the experimental received cervical injection of carboprost tromethamine 250 μg. The postpartum bleeding volume at different time points,the perioperative period index,the total treatment efficiency and the adverse drug reactions were recorded and compared between 2 groups. At the same time,the maternal ultrasound examination was performed in post-caesarean women 2 weeks after operation to understand the recovery of the uterus. RESULTS After treatment,the total treatment efficiency of the experimental group was 95. 0%,which was significantly higher than that of the control group ( 80. 0%,P < 0. 05). The operation time,the ambulation time and the hospitalization time were significantly shorter of the experimental group than those of the control group,and the 2 h and 24 h total amount of bleeding after operation was significantly lower than that of the control group,and there was significant difference ( P < 0. 05). There was no significant difference in the incidence of complications,such as nausea,vomiting and diarrhea between 2 groups ( P > 0. 05). Ultrasound examination results showed that the cesarean section uterine involution of 2 groups was good. CONCLUSION Compared with the arm deltoid intramuscular injection,cervical injection of carboprost tromethamine can significantly reduce postpartum hemorrhage and promote maternal prognosis,which is effective and safe,and is worthy of clinical

关 键 词：难治性产后出血 卡前列素氨丁三醇 给药方式 临床疗效 安全性 

分 类 号：R714.461[医药卫生—妇产科学]