标题：卡前列甲酯栓与米索前列醇在足月阴道分娩产后出血中的应用

      作者：叶晖，崔洁，刘燕    宝鸡市中医医院产科，陕西 宝鸡 721001

      卷次： 2021年32卷18期

      【摘要】 目的 探讨卡前列甲酯栓与米索前列醇预防和减少足月阴道分娩产后出血的有效性。方法 选择2018年3月至2020年3月宝鸡市中医医院产科收治的56例足月阴道分娩产妇为研究对象，按照随机数表法将产妇分为对照组和观察组各28例。观察组产妇接受卡前列甲酯栓预防治疗，对照组产妇接受米索前列醇预防治疗。治疗后比较两组产妇的产后出血发生率、药物不良反应发生率、产后2 h和24 h出血量、产后24 h血清一氧化氮(NO)及一氧化氮合成限速酶(NOS)水平、产程时间和止血时间；随访1个月，比较两组产妇的恶露排净时间。结果 治疗后，观察组产妇的产后出血发生率及药物不良反应发生率明显低于对照组，差异均有统计学意义(P<0.05)；观察组产妇产后2 h和24 h出血量分别为(226.39±16.34) mL、(334.67±26.31) mL，明显少于对照组的(295.68±15.24) mL、(395.79±25.33) mL，差异均有统计学意义(P<0.05)；观察组产妇产后24 h血清NO及NOS水平分别为(76.39±5.91) nmol/L、(16.69±1.33) nmol/L，明显低于对照组的(86.25±5.36) nmol/L、(22.01±1.49) nmol/L，差异均有统计学意义(P<0.05)；观察组产妇的产程时间、止血时间分别为(15.21±2.62) h、(11.35±3.01) min，明显短于对照组的(18.36±3.56) h、(15.39±2.56) min，差异均有统计学意义(P<0.05)；随访1个月，观察组产妇的恶露排净时间为(14.15±3.26) d，明显短于对照组的(19.32±3.05) d，差异有统计学意义(P<0.05)。结论 卡前列甲酯栓能降低足月阴道分娩产后出血的发生率，减少产后出血量，临床应用疗效显著，安全性高。
      【关键词】 足月；阴道分娩；卡前列甲酯栓；米索前列醇；产后出血；有效性
      【中图分类号】 R714.3 【文献标识码】 A 【文章编号】 1003—6350（2021）18—2362—03

Efficacy of carboprost methyl ester suppository and misoprostol in reducing postpartum hemorrhage offull-term vaginal delivery.
YE Hui, CUI Jie, LIU Yan. Department of Obstetrics, Baoji Hospital of Traditional ChineseMedicine, Baoji 721001, Shaanxi, CHINA
【Abstract】 Objective To investigate the efficacy of carboprost methyl ester suppository and misoprostol in pre-venting and reducing postpartum hemorrhage in full-term vaginal delivery. Methods Fifty-six patients of full-term vag-inal delivery in Department of Obstetrics, Baoji Hospital of Traditional Chinese Medicine from March 2018 to March2020 were selected as the research objects, and they were randomly divided into the control group and the study groupaccording to random number table method, with 28 patients in each group. The study group received carboprost methylester suppository for preventive treatment, while the control group received misoprostol for preventive treatment. Aftertreatment, the incidence of postpartum hemorrhage, incidence of adverse drug reactions, 2-hour postpartum hemorrhage,24-hour postpartum hemorrhage, 24-hour postpartum serum NO and NOS levels, labor process time, and hemostasistime were compared between the two groups. Results After treatment, the incidence of postpartum hemorrhage and ad-verse drug reactions in the study group were significantly lower than those in the control group (P<0.05). The amount ofpostpartum hemorrhage in 2 hours and 24 hours after delivery in the study group were (226.39±16.34) mL, (334.67±26.31) mL, significantly lower than (295.68±15.24) mL, (395.79±25.33) mL in the control group (P<0.05). The level ofserum NO and NOS in the study group were (76.39±5.91) nmol/L, (16.69±1.33) nmol/L, significantly lower than (86.25±5.36) nmol/L, (22.01±1.49) nmol/L in the control group (P<0.05). The labor process time and hemostasis time of thestudy group were (15.21±2.62) h, (11.35±3.01) min, significantly shorter than (18.36±3.5) h, (15.39±2.56) min of thecontrol group (P<0.05). After 1 month follow-up, the lochia clearance time of the study group was (14.15±3.26) d, whichwas significantly shorter than (19.32±3.05) d of the control group (P<0.05). Conclusion Captrostamol methyl estersuppository can reduce the incidence of postpartum hemorrhage in full-term vaginal delivery, reduce the amount of post-partum hemorrhage, and has significant effect and high safety, and can promote the prognosis of the parturient.
      【Key words】 Term; Vaginal delivery; Carboprost methyl ester suppository; Misoprostol; Postpartum hemorrhage;Efficacy