卡前列素氨丁三醇注射液联合子宫动脉结扎术预防双胎妊娠剖宫产产后出血的临床观察

李春英　冯书梅

【摘要】 目的：觀察卡前列素氨丁三醇注射液联合子宫动脉结扎术预防双胎妊娠剖宫产产后出血的临床疗效。方法：采用回顾性分析的方法，将双胎妊娠剖宫产手术分娩的孕妇分为观察组和对照组，其中观察组27例，对照组23例。观察组胎儿娩出后子宫肌注卡前列素氨丁三醇注射液，同时行子宫动脉结扎术；对照组：胎儿娩出后子宫肌注缩宫素及静注缩宫素，比较两组术中、术后2 h、术后24 h出血量及产后出血发生率。结果：观察组术中、术后2 h及24 h出血量分别为（248.81±43.71）ml、（337.78±48.46）ml、（502.30±149.29）ml，明显少于对照组的（331.96±59.06）ml、（440.22±58.82）ml、（772.39±170.07）ml，差异均有统计学意义（P<0.01）；观察组产后出血量>1000 ml的2例（7.40%），对照组产后出血量>1000 ml的7例（30.43%），观察组产后出血发生率明显低于对照组，差异有统计学意义（P<0.05）。结论：双胎妊娠剖宫产预防性使用卡前列素氨丁三醇注射液并联合子宫动脉结扎术可明显降低产后出血的发生。

【关键词】 双胎妊娠； 产后出血； 卡前列素氨丁三醇注射液； 子宫动脉结扎术

中图分类号 R714.46 文献标识码 B 文章编号 1674-6805（2016）6-0020-02

The Clinical Observation of Carboprost Tromethamine Injection Combined with Uterine Artery Ligation Prevention of Postpartum Hemorrhage in Twin Pregnancy in Cesarean Section/LI Chun-ying，FENG Shu-mei.//Chinese and Foreign Medical Research，2016，14（6）：20-21

【Abstract】 Objective：To evaluate the clinical effect of Carboprost Tromethamine Injection combined with uterine artery ligation prevention of postpartum hemorrhage in twin pregnancy in cesarean section.Method：The methods of retrospective analysis was used，50 pregnant women in twin pregnancy were divided into the observation group and the control group，the observation group of 27 cases，the control group of 23 cases.After delivery of fetus，the observation group was injected Carboprost Tromethamine Injection in uterine muscle，and uterine artery was ligated，after delivery of fetus，the control group was injected Oxytocin in uterine muscle and intravenous injection of Oxytocin.The bleeding volume in operation，after 2 h，24 h and the incidence of postpartum hemorrhage were compared between the two groups.Result：The bleeding volume in operation，after 2 h，24 h in the observation group were （248.81±43.71）ml，（337.78±48.46）ml，

（502.30±149.29）ml，they were significantly less than （331.96±59.06）ml，（440.22±58.82）ml，（772.39±170.07）ml in the control group，and the differences were statistically significant（P<0.01）.Postpartum hemorrhage amount above 1000 ml in the observation group were 2 cases（7.40%），the control group were 7 cases（30.43%）， the incidence of postpartum hemorrhage in the observation group was significantly lower than that in the control group，the difference was statistically significant（P<0.05）.Conclusion：The twin pregnancy cesarean section production prophylactic use of Carboprost Tromethamine Injection combined with uterine artery ligation can significantly reduce the incidence of postpartum hemorrhage.

【Key words】 Twin pregnancy； Postpartum hemorrhage； Carboprost Tromethamine Injection； Uterine artery ligation

First-authors address：Changping Hospital of Dongguan，Dongguan 523573，China

doi：10.14033/j.cnki.cfmr.2016.6.010

產后出血是产妇死亡的主要原因。多胎妊娠其胎盘面积及子宫容积较单胎妊娠大，产后出血的风险相应增加，而选择性剖宫产进一步影响产后出血的发病率，因此积极采取有效措施预防产后出血具有重要的临床意义。以剖宫产产后24 h出血超过1000 ml者为产后出血的标准[1]，2010年1月-2014年12月笔者所在医院应用卡前列素氨丁三醇注射液联合子宫动脉结扎术预防双胎妊娠剖宫产产后出血，效果良好，报告如下。

1 资料与方法

1.1 一般资料

2010年1月-2014年12月笔者所在医院总分娩人数24 872例，选择双胎妊娠行剖宫产术分娩者50例，其中胎儿娩出后卡前列素氨丁三醇注射液联合子宫动脉结扎术者27例为观察组，胎儿娩出后子宫肌注射缩宫素及滴注缩宫素者23例为对照组。两……