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卡贝缩宫素与缩宫素用于减少非选择性剖宫产时额外宫缩剂使用的比较:一项双盲随机试验(.)

Carbetocin versus oxytocin to reduce additional uterotonic use at non-elective caesarean section: a double-blind, randomised trial (.).

作者信息

Whigham Carole-Anne, Gorelik Alexandra, Loughnan Terrence E, Trivedi Amar

机构信息

a Womens Health Unit, Sunshine Hospital , St Albans , VIC , Australia .

b Epicentre, Royal Melbourne Hospital , Parkville , VIC , Australia .

出版信息

J Matern Fetal Neonatal Med. 2016 Dec;29(23):3866-9. doi: 10.3109/14767058.2016.1149564. Epub 2016 Mar 3.

Abstract

OBJECTIVE

We compared the efficacy of Carbetocin (long-acting oxytocin receptor agonist) versus Oxytocin given at non-elective caesarean section.

METHOD

We performed a double-blind, randomised, single-centre study. Eligible women were ≥37 weeks of gestation undergoing emergency caesarean section. Participants received either carbetocin of 100 μg or oxytocin 5 international units. The primary outcome was the need to administer additional uterotonics, as determined by the clinician. Secondary outcomes included estimated blood loss, haemoglobin drop pre-post operation and the need for a blood transfusion Results: From August 2012 to February 2013, 114 women were enroled. Two were excluded from analysis as they received a general anaesthetic. Fifty-nine patients received 100-μg carbetocin; 53 received 5 international units oxytocin. There was no statistically significant difference in the number of women requiring additional uterotonics between the two groups: Carbetocin group 22% and Oxytocin group 13% (p = 0.323). There were no significant differences in the fall in haemoglobin, estimated blood loss, rates of post-partum haemorrhage or blood transfusions.

CONCLUSION

Oxytocin and carbetocin have similar requirements for additional uterotonics, estimated blood loss, haemoglobin drop and blood transfusions. There was a trend towards requiring additional uterotonics in patients receiving Carbetocin which was not statistically significant. This study found no benefits in using carbetocin over oxytocin.

摘要

目的

我们比较了卡贝缩宫素(长效催产素受体激动剂)与催产素在非选择性剖宫产中的疗效。

方法

我们进行了一项双盲、随机、单中心研究。符合条件的女性为妊娠≥37周且接受急诊剖宫产的患者。参与者分别接受100μg卡贝缩宫素或5国际单位催产素。主要结局是临床医生确定的是否需要额外使用宫缩剂。次要结局包括估计失血量、手术前后血红蛋白下降情况以及输血需求。结果:2012年8月至2013年2月,共纳入114名女性。其中2名因接受全身麻醉而被排除在分析之外。59名患者接受了100μg卡贝缩宫素;53名接受了5国际单位催产素。两组中需要额外使用宫缩剂的女性数量无统计学显著差异:卡贝缩宫素组为22%,催产素组为13%(p = 0.323)。血红蛋白下降、估计失血量、产后出血率或输血率方面均无显著差异。

结论

催产素和卡贝缩宫素在额外使用宫缩剂、估计失血量、血红蛋白下降和输血方面有相似表现。接受卡贝缩宫素的患者有额外使用宫缩剂的趋势,但无统计学显著性。本研究未发现使用卡贝缩宫素比催产素有优势。

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