卡前列甲酯栓辅助治疗子宫收缩乏力性产后出血临床观察

Clinical observation of carboprost methyl suppository in adjuvant treatment of postpartum hemorrhage caused by uterine atony

目的分析卡前列甲酯栓辅助治疗子宫收缩乏力性产后出血患者的效果。方法选取忠县人民医院产科2018-09-03-2020-12-21收治的107例子宫收缩乏力性产后出血患者作为研究对象,根据抽签的方式分为2组,对照组53例在发现出血后使用卡前列素氨丁三醇肌内注射干预,观察组54例在对照组基础上联合应用卡前列甲酯栓干预。观察2组患者的止血效果、凝血功能、子宫收缩水平、不良反应发生率。结果干预后,观察组止血时间为(2.42±0.45)h,短于对照组的(4.15±0.52)h,t=18.413,P<0.001;产后2 h出血量为(167.39±39.26)mL,低于对照组的(186.34±42.31)mL,t=2.402,P=0.018;产后24 h出血量为(180.40±40.29)mL,低于对照组的(216.49±45.19)mL,t=4.362,P<0.001。干预后,观察组凝血酶原时间(PT)为(12.77±4.76)s,低于对照组的(16.26±3.56)s,F=6.070,P=0.023;活化部分凝血活酶时间(APTT)为(32.29±1.08)s,低于对照组的(37.57±1.98),F=4.918,P<0.001;凝血酶时间(TT)为(16.21±0.67)s,低于对照组的(16.98±0.07)s,F=8.410,P<0.001;D-二聚体(D-D)水平为(1.16±0.46)mg/L,低于对照组的(2.04±0.12)mg/L,F=14.809,P<0.001。干预后,观察组子宫收缩持续时间为(3.65±1.15)h,高于对照组的(2.32±0.25)h,F=15.943,P<0.001;子宫底下降速度为(1.65±0.59)cm/d,高于对照组的(1.26±0.13)cm/d,F=15.699,P<0.001;纤维蛋白原(FIB)水平为(3.42±0.38)g/L,高于对照组的(2.01±0.44)g/L,F=7.428,P<0.001。2组患者不良反应发生率比较,差异无统计学意义,P>0.05。结论子宫收缩乏力性产后出血患者使用卡前列甲酯栓辅助治疗止血效果好,能够改善患者凝血功能,增加子宫收缩力,安全性高。

Objective To analyze the effect of methyl carprost suppository on postpartum hemorrhage caused by uterine weakness.Methods A total of 107 patients with postpartum hemorrhage due to uterine atony admitted to the obstetrics department of Zhongxian People’s Hospital from September 3,2018 to December 21,2020 were selected as the research object.They were divided into two groups according to the way of drawing lots.The control group(53 cases)used carboprost tromethamine intramuscular injection to intervene after finding hemorrhage,and the intervention group(54 cases)used carboprost methyl suppository to intervene on the basis of the control group.The hemostatic effect,coagulation function,uterine contraction level and adverse reaction rate of the two groups were observed.Results After intervention,the hemostatic time in the intervention group was(2.42±0.45)h,shorter than that in the control group(4.15±0.52)h,t=18.413,P<0.001.The amount of postpartum hemorrhage was(167.39±39.26)ml,which was lower than that of the control group(186.34±42.31)ml,t=2.402,P=0.018.The amount of postpartum hemorrhage was(180.40±40.29)ml,which was lower than that of the control group(216.49±45.19)ml,t=4.362,P<0.001.The prothrombin time(PT)in the intervention group was(12.77±4.76)s,which was lower than that in the control group(16.26±3.56)s,F=6.070,P=0.023.The activated partial thromboplastin time(APTT)was(32.29±1.08)s,lower than that of the control group(37.57±1.98),F=4.918,P<0.001.Thrombin time(TT)was(16.21±0.67)s,lower than that of the control group(16.98±0.07)s,F=8.410,P<0.001.The level of D-dimer(D-D)was(1.16±0.46)mg/L,lower than that of the control group(2.04±0.12)mg/L,F=14.809,P<0.001.The duration of uterine contraction in the intervention group was(3.65±1.15)h,higher than that in the control group(2.32±0.25)h.F=15.943,P<0.001.The descending speed of the fundus of uterus was(1.65±0.59)cm/d,which was higher than that of the control group(1.26±0.13)cm/d,F=15.699,P<0.001.The level of fibrinogen(FIB)was(3.42±0.38)g/L,higher than that of the control group(2.01±0.44)g/L,F=7.428,P<0.001.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The use of carboprost methyl ester suppository in the treatment of postpartum hemorrhage caused by uterine atony has good hemostatic effect,can improve the patient’s blood coagulation function,increase the uterine contractility,and has high safety.