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目的探讨卡前列素氨丁三醇联合米索前列醇应用于防治多次剖宫产孕产妇再次剖宫产术后出血的疗效。方法将2014年1月至2017年2月收治的≥2次剖宫产手术史再次妊娠至足月行剖宫产的单胎活产孕妇180例随机分为观察组和对照组,每组90例。观察组在剖宫产术中胎儿娩出后予以子宫体肌注卡前列素氨丁三醇250μg,剖宫产术后予以米索前列醇400μg直肠置入。对照组在剖宫产术中胎儿娩出后予以缩宫素20 IU子宫体肌肉注射。比较两组术中出血量、术后2 h及术后24 h出血量、术后输血患者例数、子宫切除的发生率。结果观察组术中出血量、术后2h出血量及术后24 h出血量均少于对照组(P<0.05),输血率及子宫切除发生率也低于对照组(P<0.05)。结论卡前列素氨丁三醇联合米索前列醇预防多次瘢痕子宫再次剖宫产产后出血疗效效果显著,可降低术后并发症发生率,值得临床推广应用。
Objective To investigate the effect of carboprost trometamol combined with misoprostol in the prevention and treatment of multiple cesarean section after maternal cesarean section bleeding again. Methods One hundred and eighty pregnant women with single childbirth who underwent cesarean section with ≥2 cesarean section surgeries from January 2014 to February 2017 were randomly divided into observation group and control group example. Observation group in the cesarean section after the fetus was delivered to the uterine muscle card card tranexamine trometamol 250μg, cesarean section to be misoprostol 400μg rectal implants. Control group in the cesarean section after the fetus was delivered oxytocin 20 IU uterine muscle injection. The amount of bleeding during operation, the amount of blood loss at 2 hours and 24 hours after operation, the number of transfused patients and the incidence of hysterectomy were compared between the two groups. Results The intraoperative blood loss, blood loss at 2h after operation and the amount of hemorrhage at 24 h after operation were lower in the observation group than those in the control group (P <0.05). The incidences of transfusion and hysterectomy were also lower than those in the control group (P <0.05). Conclusion The combination of carboprost trometamol and misoprostol is effective in preventing post-cesarean section postpartum hemorrhage after multiple uterine scarring, which can reduce the incidence of postoperative complications and is worthy of clinical application.