欣母沛治疗42例产后出血临床观察.docVIP

欣母沛治疗42例产后出血临床观察 　　[摘 要]目的：观察欣母沛（氨丁卡前列素）用于治疗宫缩乏力所致的产后出血的疗效。方法：对宫缩乏力所致的产后出血患者用常规方法治疗无效后，采用欣母沛宫体或宫颈注射，重复使用可间隔15分钟。结果：42名患者，39例有显著效果，有效率为92.8%。无效3例，1例合并绒毛膜羊膜炎，另2例并发DIC。结论：欣母沛治疗宫缩乏力性产后出血效果显著，但应明确诊断，早期使用。 　　[关键词]：宫缩乏力;产后出血;欣母沛（氨丁卡前列素） 　　A clinical study on controlling atonic postpartum hemorrhage with hemabate sterile solution 　　Fu zhao xia 　　Zigong Fourth people’s Hospital of Sichuan province 643000 　　Abstract：Objective： To observe curative effect of intrauterinely injected Hemabate sterile solution（15-methylprostaglandin F2a-tromethamine ）for controlling atonic postpartum hemorrhage Methods： The women who had postpartum hemorrhage caused by uterine atony were conduted an injection of Hemdbate sterile solution intrauterinely or intracervically，after no response to conventional thearapies， The time interval between multiple doses is about 15 minutes. Results： The hemorrhage was successfully controlled immediately after administration of Hemabate sterile solution in 39 of 42 cases. The effective rate was 92.8% .tree cases failed， of which one patient was complicated by chorioamnionitis， and the remaining two cases was complicated by disseminated intravascular coagulation（DIC）. Conclusion： Hemabate sterile solution appeared very effective for treatment of severe atonic postpartum hemorrhage and had few side effects under condition of determined diagnosis and early administration of the drug. 　　Key words： uterine atony; postpartum hemorrhage; Hemabate （carboprost trometamol） 　　产后出血是产科的严重并发症之一，是我国孕产妇死亡的首要原因。[1]经报道2001年美国产后出血发生率约为12.3%。产后出血的主要原因是子宫收缩乏力，目前多数医院宫缩剂应用主要为缩宫素、麦角新碱及卡前列栓，但有时效果不佳，只能手术结扎子宫动脉、髂内动脉、甚至行子宫次全切除术。笔者采用欣母沛（Hemabate，氨丁卡前列素注射液）治疗42例产后出血，取得了良好的效果。现报道如下。 　　1 资料与方法 　　1.1 研究对象 　　所有研究对象均为医院2009年5月～2013年6月产科住院宫缩乏力性产后出血患者共42例。其中早期产后出血33例，晚期产后出血6例，孕中期引产后出血3例，初产妇36例，经产妇11例，平均年龄28岁，有妊娠并发症及合并症者26例;妊娠高血压综合征16例，双胎1例，巨大儿1例、前置胎盘1例、前次剖宫产史3例、甲状腺功能亢进2例、糖尿病2例。 　　1.2药物与方法 　　1.2.1药物 　　欣母沛（Hemabate，氨丁卡前列素250μg/1ml）由美国法玛西亚普强（中国）公司提供。在常规物理、药物治疗无效时用欣母沛宫体注射27例，宫颈注射7例，肌肉注射