首页> 中文期刊> 《海南医学》 >卡贝缩宫素对妊娠疤痕子宫剖宫产术中出血量及子宫肌层厚度的影响

卡贝缩宫素对妊娠疤痕子宫剖宫产术中出血量及子宫肌层厚度的影响

         

摘要

Objective To explore the effect of carbetocin on operative blood loss and uterine muscular layer thickness during cesarean section, and provide theoretical basis for clinical work. Methods A total of 282 cases of preg-nant women, who admitted to Department of Gynecology and Obstetrics in our hospital from January 2012 to June 2014, were selected and randomly divided into the observation group and the control group according to the random number ta-ble, with 141 patients in each group. In cesarean section, the observation group received one-time injection of carbetocin, and the control group underwent one-time injection of oxytocin. The operation time, hospitalization time, uterine contrac-tion effect, blood loss after operation, uterine muscular layer thickness, postoperative life indications and complications of the two groups were compared. Results The operation time of the observation group (94.4 ± 11.4) min was signifi-cantly shorter than that of the control group (121.2 ± 8.3) min, P<0.05. The rate of good uterine contraction effect of the observation group 86.5%(122/141) was significantly better than that of the control group 74.2%(105/141), P<0.05. The postoperative blood loss in the observation group (218 ± 47.3) mL was significantly less than that in the control group (319.2 ± 77.9) mL, P<0.05. The uterine muscular layer thickness (including anterior uterine wall, posterior uterine wall and uterine fundus) of the observation group ((8.42±1.24) mm, (8.12±1.48) mm and (8.61±1.35) mm, respectively) was significantly thicker than that of the control group ((6.48±1.52) mm, (6.94±1.31) mm and (7.03±1.12) mm, respectively], P<0.05. There was no significant difference between the observation group 6.4%(9/141) and the control group 9.2%(13/141) in the complications (P>0.05). Conclusion Carbetocin can significantly reduce blood volume, improve the quality of life of pregnant women in long term, and improve the effective thickness of anterior and posterior uterine wall and pelvic floor muscular layer, which is safe and effective, and worthy of clinical application.%目的:探讨卡贝缩宫素对妊娠疤痕子宫行剖宫产手术的出血量及子宫肌层厚度的影响,以期为临床工作提供理论依据。方法将2012年1月至2014年6月于我院妇产科接受剖宫产分娩的282例孕妇纳入研究,将孕妇按照随机数表法随机分为观察组和对照组,每组141例。观察组孕妇于宫体处接受一次性注射卡贝缩宫素,对照组孕妇接受一次性注射缩宫素,比较两组孕妇的手术时间、住院时间、宫缩效果、术后出血量、子宫肌层厚度、术后生命指征以及并发症发生情况。结果观察组产妇的手术时间为(94.4±11.4) min,与对照组的(121.2±8.3) min比较明显缩短,差异有统计学意义(P<0.05);观察组产妇的宫缩效果优占86.5%(122/141),明显优于对照组的74.2%(105/141),差异有统计学意义(P<0.05);观察组产妇术后出血量为(218±47.3) mL,明显少于对照组的(319.2±77.9) mL,差异有统计学意义(P<0.05);观察组子宫肌层厚度包括子宫前壁、后壁及宫底均明显厚于对照组[(8.42±1.24) mm vs (6.48±1.52) mm、(8.12±1.48) mm vs (6.94±1.31) mm、(8.61±1.35) mm vs (7.03±1.12) mm],差异有统计学意义(P<0.05)。而在并发症方面,观察组产妇6.4%(9/141),与对照组的9.2%(13/141)相当,差异无统计学意义(P>0.05)。结论剖宫产术中使用卡贝缩宫素能够明显降低术中出血量,提高产妇远期生活质量、提高有效子宫前后壁和盆底肌层厚度,安全有效,值得临床推广应用。

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