吴云波 吴娟

[摘要] 目的 探讨卡前列甲酯栓对产后出血的应用价值及应用时机。 方法 使用前瞻性随机分组方法，将正常足月妊娠阴道分娩的产妇200例分为三组：卡前列甲酯栓产前组于第二产程末胎头已着冠，估计于1～2个宫缩娩出时肛塞卡前列甲酯栓1 mg；卡前列甲酯栓产后组于胎儿娩出后立即给予相同的处理；对照组于胎儿娩出后立即给予缩宫素20 IU经腹壁宫体注射。比较第三产程和产后出血量。 结果 卡前列甲酯栓产前组的第三产程时间明显短于产后组和对照组（P＜0.01），产后出血量也明显减少。 结论 卡前列甲酯栓在产前应用可有效预防产后出血的发生。

[关键词] 产后出血；卡前列甲酯栓；预防

[中图分类号] R714.461 [文献标识码] B[文章编号] 1673-9701（2012）02-0153-02

Observation on the Carboprost Methylate suppository in reducing postpartum hemorrhage

WU Yunbo WU Juan

Department of Obstetrics and Gynecology, Kunming Tongren Hospital, Kunming 650228, China

[Abstract] Objective To study points of attention in prevention and management about postpartum hemorrhage. Methods Using a prospective randomized grouping method,the normal term pregnancy vaginal delivery in a parturient with 200 cases into three groups, Carboprost prenatal group in the second stage of labor at the end of the fetal head was a crown, estimated in 1 ~ 2 uterine delivery of methyl carprost suppository anal plug 1 mg, Carboprost postpartum group in the delivery of the fetus was given immediately after the same treatment. The control group in the delivery of the fetus was given immediately after uterine contraction and 20 IU transabdominal uterine body injection, comparison of third labor and postpartum hemorrhage volume. Results Carboprost prenatal group of third labor time was shorter in the postnatal group and control group (P＜0.01), postpartum hemorrhage volume was significantly reduced. Conclusion Methyl Carprost Suppository in prenatal application can effectively prevent the occurrence of postpartum hemorrhage.

[Key words] Postpartum hemorrhage; Carboprost Methylate suppository; Prevention

产后出血是产科临床常见的严重并发症之一，是当前我国孕妇死亡的首位原因。产后出血的主要原因是子宫收缩乏力，积极防治子宫收缩乏力性出血是降低孕产妇病死率的关键。目前临床上统一的产后出血定义[1]是胎儿娩出后24h内，阴道流血量超过500mL者，其中主要发生在第三产程和产后2h内。近几年来临床上应用前列腺素增强子宫收缩取得了明显疗效。我院近期将卡前列甲酯栓用于具有产后出血高危因素的产妇预防产后出血，取得较好效果，现报道如下。

1 资料与方法

1.1 研究对象

选择2010年5月～2011年5月在我院住院分娩的产妇200例，均为初次、正常足月妊娠分娩，无前列腺素使用禁忌证，无产科高危因素及产科并发症，临产前1周未使用前列腺素；……