【摘要】 目的评估国产卡前列素氨丁三醇(商品名:安列克)防治高危产妇剖宫产术中及术后出血的有效性和安全性。方法将2011年3月至12月就诊于广东9家医院具有出血高危因素行剖宫产术的产妇360例患者,按胎儿娩出后宫体注射子宫收缩药物的不同分成3组:A组(注射缩宫素),B组(注射缩宫素和卡前列素氨丁三醇组),C组(注射卡前列素氨丁三醇),每组各120例,分析比较各组术中、术后2 h及术后24 h出血量及药物副作用的情况。结果 B组术中、术后2 h、术后24 h出血量[分别为(331.4±209.7)ml,(421.8±239.2)ml,(593.6±242.3)ml]明显低于A组[分别为(417.3±235.2)ml,(613.4±301.9)ml,(685.7±296.1)ml],差异均有统计学意义(P<0.05);C组[分别为(352.5±253.4)ml,(479.4±201.7)ml,(607.1±246.6)ml]也明显低于A组,差异均有统计学意义(P<0.05);而B组与C组比较,差异均无统计学意义(P>0.05)。360例产妇,发生产后出血有42例,产后出血发生率为11.7%。A组产后出血的发生率(18.3%,22/120)明显高于B组(7.5%,9/120)和C组(9.2%,11/120),2=6.145、3.596,差异均有统计学意义(P<0.05);B组和C组治疗性宫缩剂的应用百分率[(分别为(11.1%,1/9)、(18.2%,2/11)明显少于A组(68.2%,15/22),2=10.190、8.164,差异均有统计学意义(P<0.05)。360例使用宫缩剂的患者中,有27例发生1种或以上的副作用,发生率为7.5%。B组副作用的发生率(12.5%,15/120)高于A组(3.3%,4/120)和C组(6.7%,8/120),2=12.451、9.254,差异均有统计学意义(P<0.05);但各种副反应的发生率在3组患者间的比较差异均无统计学意义(P>0.05)。结论卡前列素氨丁三醇预防和治疗高危产妇剖宫产术中及术后出血安全有效,但要密切注意药物副作用。更多还原

【Abstract】 Objective To evaluate the curative effect and safety of domestic Carboprost Tromethamine( trade name: An Lie ke) on preventing intraoperative hemorrhage and postoperative hemorrhage of high risk pregnant women with cesarean section. Methods Three hundred and sixty pregnant women,who were admitted into 9 hospitals of Guangdong province from March to December 2011,had cesarean section due to bleeding high risk factors. According to the oxytocic drugs injected in the uterine body after delivery,360 pregnant women were divided into 3 groups: group A( only injected· 721·oxytocin),group B( injected oxytocin plus Carboprost Tromethamine) and group C( only injected Carboprost Tromethamine). There were 120 patients in each group. The amount of bleeding was observed during operation,2 hours after operation and 24 hours after operation,respectively. The amount of bleeding in each observation time and oxytocic drug side effects of the 3 groups were compared. Results In group B,the amount of bleeding were(331. 4 ± 209. 7)ml,(421. 8 ± 239. 2)ml and(593. 6 ± 242. 3)ml during operation,2 hours after operation and 24 hours after operation,respectively,which were significantly less than those in group A[(417. 3 ± 235. 2)ml,(613. 4 ± 301. 9)ml and(685. 7 ± 296. 1)ml]( P < 0. 05).In group C,the amount of bleeding were(352. 5 ± 253. 4)ml,(479. 4 ± 201. 7)ml and(607. 1 ± 246. 6)ml during operation,2 hours after operation and 24 hours after operation,respectively,which were also significantly less than those in group A(P < 0. 05). But there was no significant difference between group B and group C(P > 0. 05). Totally,42 cases of 360 cases were postpartum hemorrhage,which incidence rate was 11. 7%. The incidence rate of postpartum hemorrhage in group A( 18. 3%,22 /120) was significantly higher than that in group B(7. 5%,9 /120) and group C(9. 2%,11 /120),( 2= 6. 145 and3. 596,P value < 0. 05). The usage rate of extra oxytocic drugs was 11. 1%(1 /9) in group B and 18. 2%(2/11) in group C,which were significantly lower than that in group A(68.2%,15/22),( 2= 10. 190 and 8. 164,P value < 0. 05). Among the 360 patients,27 patients had 1 or more adverse reactions; the incidence rate was 7. 5%. The incidence rate of adverse reaction in group B(12. 5%,15 /120) was higher than those in group A(3. 3%,4 /120) and in group C(6. 7%,8 /120),( 2= 12. 451 and 9. 254,P value < 0. 05). But the incidence rate of each side reaction had no significant difference in the 3 groups(P value >0.05). Conclusions Domestic Carboprost Tromethamine was effective and safe for high risk pregnant women with cesarean section to prevent intraoperative hemorrhage and postoperative hemorrhage.But the side effects need to be closely observed.更多还原