龚春桃 高艳杰

[摘要] 目的 探討卡前列素氨丁三醇联合卡贝缩宫素对前置胎盘剖宫产产后出血的效果观察。 方法 选取2018年5月至2020年5月我院收治的前置胎盘剖宫产产后出血患者76例，抓阄法分为对照组和研究组两组，每组38例。两组均进行常规剖宫产手术，对照组应用卡贝缩宫素治疗，研究组应用卡前列素氨丁三醇联合卡贝缩宫素治疗。观察对比两组患者的治疗总有效率，治疗中不良反应的发生率以及术中、手术3 h和24 h后的出血量。 结果 研究组治疗总有效率（94.7%）优于对照组（89.5%）（P<0.05）;研究组不良反应发生率（10.5%）低于对照组（28.9%）（P<0.05）;研究组术中出血量[（203.5±35.1）mL]、术后3h[（247.4±46.3）mL]及24h的出血量[（294.6±73.4）mL]低于对照组[（357.4±85.2）mL、（417.6±86.3）mL、（501.8±97.6）mL]，研究组产后出血率（7.9%）低于对照组（18.4%）（P<0.05）。结论 卡前列素氨丁三醇联合卡贝缩宫素对前置胎盘剖宫产产后出血的效果理想，可提高治疗效果，降低不良反应的发生，临床上应当进一步推广应用。

[关键词] 卡前列素氨丁三醇;卡贝缩宫素;前置胎盘剖宫产;产后出血;应用效果

[中图分类号] R714.461          [文献标识码] B          [文章编号] 1673-9701（2021）07-0078-03

The efficacy of carboprost tromethamine combined with carbetocin on postpartum hemorrhage after cesarean section for placenta previa

GONG Chuntao   GAO Yanjie

Department of Obstetrics， Huangshi Love & Health Hospital in Hubei Province， Huangshi   435000， China

[Abstract] Objective To investigate the efficacy of carboprost tromethamine combined with carbetocin on postpartum hemorrhage（PPH） after cesarean section for placenta previa. Methods A total of 76 patients with PPH after cesarean section for placenta previa admitted to our hospital from May 2018 to May 2020 were selected， and they were divided into the control group（n=38） and the study group（n=38） by drawing lots. All patients enrolled underwent conventional cesarean section， the control group was treated with carbetocin， while the study group was treated with carboprost tromethamine combined with carbetocin. The response rate， the incidence of adverse reactions（ADRs） during the treatment and the hemorrhage volume during the surgery， within 3 hours and 24 hours after operation were observed and compared between the two groups. Results The total response rate of the study group was 94.7%， which was better than 89.5% of the control group（P<0.05）. The incidence of ADRs in the study group was 10.5%， which was lower than 28.9% in the control group（P<0.05）. The hemorrhage volume during the surgery， within 3 hours and 24 hours after operation of the study group were lower than those of the control group [（203.5±35.1） mL vs （357.4±85.2） mL， （247.4±46.3） mL vs （417.6±86.3） mL and （294.6±73.4） mL vs （501.8±97.6） mL， respectively]. Meanwhile， the postpartum hemorrhage rate of the study group was 7.9%， which was lower than 18.4% of the control group（P<0.05）. Conclusion The carboprost tromethamine combined with carbetocin is effective in the treatment of postpartum hemorrhage after cesarean section for placenta previa， which can improve the treatment efficacy and reduce the occurrence of ADRs. Therefore， it should be further promoted and applied in clinic.

[Key words] Carboprost tromethamine; Carbetocin; Cesarean section for placenta previa; Postpartum hemorrhage; Application efficacy

前置胎盤是产科中常见的并发症，由于产妇的生育年龄增高，前置胎盘的发生率也逐步增高[1]。前置胎盘的产妇需要终止妊娠，最有效的方法就是剖宫产。但是剖宫产后容易出现出血、止血困难等现象，严重的产妇需要进行子宫切除，影响产妇的生命以及生活质量[2]。前置胎盘的产妇产后通常都会有宫缩乏力的症状，是重要的影响产后出血的因素。因此在前置胎盘产妇剖宫产出血后治疗的重点就是治疗宫缩乏力症状。相对于传统的宫腔纱布填塞以及缩宫素治疗，相关文献记载，卡贝缩宫素联合卡前列素氨丁三醇治疗效果明显[3]。我院将卡前列素氨丁三醇联合卡贝缩宫素治疗前置胎盘剖宫产产后出血取得了满意效果，现报道如下。

1 资料与方法

1.1一般资料