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目的调查剖宫产术中术后出血加用卡贝缩宫素的治疗效果,分析卡贝缩宫素用药时机的不同对预防、治疗效果的影响。方法选择321例择期剖宫产术分娩的产妇,采用3种用药方式:其一宫体注射和静脉滴入均为缩宫素;其二宫体注射采用的是缩宫素,而卡贝缩宫素静脉滴入的时间为手术中胎儿娩出时胎盘娩出前;其三缩宫素使用方法同二,但卡贝缩宫素的滴入为胎盘娩出后发生产后出血时。产妇用抽签方式选择用药方法,将321例产妇分为3组,分别为缩宫素组107例、胎盘娩出前组107例、胎盘娩出后组107例。观察指标有术中、术后2h、术后24h出血量及血红蛋白、血球压积、心率、血压。结果缩宫素组患者不同时间段的出血量均明显高于胎盘娩出前组、胎盘娩出后组,差异较大;胎儿娩出时胎盘娩出前组滴入卡贝缩宫素的产妇出血量少于胎盘娩出后组,差异有统计学意义(P<0.05)。3组产妇的血红蛋白、血压等数据也存在明显差异,差异有统计学意义(P<0.05)。导致产妇出血的不同原因并不会影响卡贝缩宫素的临床效果,无论胎盘娩出前、胎盘娩出后均能起到良好的止血效果,不良反应发生率并不会明显上升,差异较小,无统计学意义(P>0.05)。结论胎儿娩出时采用卡贝缩宫素可起到预防与治疗剖宫产术中术后出血的效果。
Objective To investigate the effect of postoperative bleeding in cesarean section plus carbetocin and analyze the effect of different timing of carbetocin treatment on prevention and treatment. Methods 321 cases of women who were delivered by elective cesarean section were selected. There were 3 modes of administration: one is oxytocin and the other is oxytocin; the other is oxytocin Intrauterine intravenous infusion of time for the operation of the fetus during delivery of the placenta before delivery; the third oxytocin use the same method, but Carbetocin injection of the placenta after delivery occurs postpartum hemorrhage. Maternal selection by way of lottery medication, the 321 cases of mothers were divided into 3 groups, respectively, 107 cases of oxytocin group, 107 cases of pre-delivery of the placenta, placenta after delivery of 107 cases. Observations were intraoperative, 2h after surgery, 24h after the amount of bleeding and hemoglobin, hematocrit, heart rate, blood pressure. Results In the oxytocin group, the amount of bleeding during different time periods was significantly higher than that of the pre-placenta group and the placenta group after the delivery of the placenta. The amount of bleeding in the pre-placenta group was less than that in the pre-carpal oxytocin group After the placenta was delivered, the difference was statistically significant (P <0.05). There were also significant differences in hemoglobin and blood pressure between the three groups (P <0.05). The different causes of maternal bleeding did not affect the clinical efficacy of carbetocin. No matter the placenta was delivered, the placenta could play a good hemostatic effect after delivery, the incidence of adverse reactions did not significantly increase, the difference was small, No statistical significance (P> 0.05). Conclusion The use of carbetocin during the delivery of fetus can prevent and treat postoperative bleeding during cesarean section.