Clinical Study On Adverse Reactions Of Cesarean Section Patients Caused By Reduction Of Carboprost Tromethamine Because Of Penehyclidine Hydrochloride

Placenta previa, and other abnormal uterine scar pregnancy usually requires the use of cesarean section, but after such a cesarean section surgery often occurs in the fetus poor uterine contraction, resulting in increased bleeding. Postpartum hemorrhage is one of the serious complications of obstetrics, which is the leading cause of maternal death. Carboprost tromethamine injection is a synthetic prostaglandin F2a (PGF2a), in the prevention or treatment of postpartum uterine inertia causing bleeding efficiency of 94.9% to 99%, but its nausea, vomiting, chest tightness, palpitations and facial flushing and other adverse reaction rate is very high. Mainly Carboprost tromethamine prostaglandins have a similar composition effect. Uterus after local injection of uterine smooth muscle contraction while some is absorbed into the bloodstream, it will stimulate the gastrointestinal tract and bronchial smooth muscle, the extensive use of Shihai caused by vascular smooth muscle contraction.Changtuoning namely hydrochloric Penehyclidine (PHC) which is independently developed by China anticholinergic drugs selectively acting on M1 and M3 receptors.However, no significant effect on the M2 receptors, with a strong and comprehensive anti-gall central and peripheral base effect, can block the central and peripheral cholinergic nerve stimulant smooth muscle and smooth muscle spasm treatment.Hydrochloric Penehyclidine also help improve microcirculation, capillary wall permeability reduction and reduction of the protective effect of lysosomal release of multiple organ. Based on the above background, the present study is to observe the maternal tromethamine intramuscular Carboprost ammonia uterus, the changes of maternal plasma gastrin, motilin and angiotensin-Ⅱ, etc., to evaluate hydrochloric penehyclidine Clinical efficacy in the treatment and analysis of ether Carboprost tromethamine cesarean section causing adverse reactions possible mechanism.ObjectiveDiscussion hydrochloric Penehyclidine reduce Carboprost tromethamine cesarean section caused adverse reactions possible mechanism to evaluate the clinical efficacy for the prevention and treatment of Carboprost tromethamine cesarean section caused by adverse reactions to provide a new and more effective treatment.Materials and Methods1. StudyContinuous observation of uterine inertia presence of risk factors (prolonged labor, placenta previa, uterine scar, multiple pregnancy, fetal macrosomia, polyhydramnios and previous history of postpartum uterine inertia, etc.) elective term, morning at 8 o’clock to 11 o’clock,180 cases of maternal line cesarean delivery,150 cases randomly selected as the research object.ASA grade Ⅰ～Ⅱ level. Exclusion criteria:Merge with severe pregnancy-induced hypertension; preoperative nausea, vomiting, gastritis, diarrhea and fever symptoms in patients.2. Research Methods2.1 GroupingWere randomly divided into three groups, each group of 50 cases Group A:Dexamethasone+tropisetron group; Group B:Dexamethasone+hydrochloride penehyclidine group; Group C:Dexamethasone+tropisetron+hydrochloride penehyclidine group; A and B group were with saline group C with constant volume.2.2 AnesthesiaContinuous monitoring of the patient into the operating room after the ECG, SPO2, RR, HR, SBP, DBP, using left lateral lumbar spinal 2-3 or 3-4, spinal-epidural anesthesia. After the successful adoption of epidural spinal needle within the needle puncture, see cerebrospinal give ropivacaine (Naropin) 15mg(1% ropivacaine 1.5ml with 0.9% NaCl solution was diluted to 2ml). Unplug the spinal epidural needle 0.9% NaCl 5ml solution, successfully epidural catheter use. After the puncture is completed quickly supine, adjusting anesthesia control in T6-T8-S5, feasible slightly lower position on the left, to prevent supine hypotension syndrome. If excessive drop in blood pressure patients given ephedrine or methoxamine symptomatic treatment not included in the experiment. When the results are not satisfactory spinal anesthesia, epidural give 2% lidocaine 7-10ml.2.3 ProcessingIn the decision to use Carboprost tromethamine line immediately:A group of intravenous dexamethasone 10mg+5mg Tropisetron; group B intravenous dexamethasone 10mg+lmg hydrochloride penehyclidine; group C intravenous dexamethasone 10mg+ 5mg tropisetron+1mg hydrochloride penehyclidine. After delivery of the placenta,with oxytocin invalid, uterine body intramuscular Carboprost tromethamine 250 ug.2.4 detection index2.4.1 Determination of gastrinTake 2ml venous blood stored in EDTA tube, mixing 20min after centrifugation 20min, the supernatant was collected. Enzyme-linked immunosorbent assay (ELISA) was used to detect maternal plasma gastrin (GAS) concentrations.2.4.2 Determination of motilinTake 2ml venous blood stored in EDTA tube, mixing 20min after centrifugation 20min, the supernatant was collected. Using an enzyme-linked immunoassay (ELISA) was used to detect maternal plasma motilin (MTL) concentrations.2.4.3 Determination of angiotensin-IIThe pre-EDTA tube placed on ice, collected through the cubital vein blood 2ml, adding 20ul inhibitor immediately after the blood, low temperature plasma centrifugal extraction. Using magnetic particle chemiluminescent assay for quantification of the content of the maternal plasma angiotensin II.2.5 Monitoring Indicators2.5.1 vital signs monitoringMonitoring and recording of maternal burglary before and after each time point were anesthetized using Carboprost tromethamine, hydrochloric acid and other penehyclidine around maternal SPO2, RR, HR, SBP and DBP values.2.5.2 Complications MonitoringThe main adverse symptoms observed and recorded after each group of mothers using Carboprost tromethamine and the number of cases appeared after using hydrochloric acid and other drugs penehyclidine handle changes in the occurrence of adverse symptoms, as well.3. Statistical analysisUsing SPSS 16.0 for statistical analysis. Measurement data were presented as mean±standard deviation(x±s), said the group and between groups were compared using analysis of variance; count data were compared using the chi-square test; grade data using rank sum test.results1.Compared with the previous tromethamine injection Carboprost ammonia Palace: After injection 10min,20min, A group of maternal SBP, DBP, HR, RR increased significantly, SPO2 significantly lower (P<0.05); B, C groups did not change significantly (P> 0.05).2. B group compared with group A:nausea, vomiting incidence difference was not statistically significant, but the degree of nausea in group B than in group A was significantly lighter (P<0.05); chest tightness, palpitations and facial flushing incidence of group B was significantly lower than in group A (P<0.05). Group C nausea, vomiting, chest tightness, palpitations and facial flushing was significantly lower than A, B groups (P<0.05).3. Before the Palace injection Carboprost tromethamine comparison:at each time point after injection, three groups of maternal plasma gastrin concentrations did not change significantly; compare differences among the three groups was not statistically significant.4 After tromethamine injection Carboprost ammonia Palace, three groups of maternal plasma motilin concentration showed an upward trend. Compared with the previous injection:A, B groups rose more obvious and consistent peak time, peak concentrations at each time point and after concentration was not significantly different between the two groups, no statistically significant; group C increased compared with A, B groups obvious, although consistent with the peak time, but the peak concentration was significantly lower than A, B two groups at each time point after concentration was significantly lower than A, B groups, the difference was statistically significant (P<0.05).5. After the Palace injection Carboprost tromethamine, three groups of maternal plasma angiotensin II concentration showed an upward trend. Compared with the previous injection:A group of the most significant increase (P<0.05), group B and group C rise obvious. B, C was not significantly different between the two groups, but compared with the A group, the difference was significant, statistically significant (P<0.05).conclusionHydrochloric Penehyclidine can effectively reduce Carboprost tromethamine nausea and vomiting caused by digestive system adverse reactions, and tropisetron and dexamethasone combined with a more significant effect. Meanwhile hydrochloric Penehyclidine also effectively control Carboprost tromethamine induced chest tightness, shortness of breath and other respiratory and blood pressure, adverse reactions palpitations, increased heart rate, such as the circulatory system.