卡前列素氨丁三醇联合垂体后叶素对产后出血患者凝血功能影响

Effect of carboprost tromethamine combined with pituitrin on coagulation function in patients with postpartum hemorrhage

目的产后出血是导致围产期产妇死亡的主要原因,严重威胁产妇生命安全,而产后宫缩乏力是诱发产后出血的主要原因,临床针对产后出血患者及时促进宫缩,以减少产后出血量,改善机体凝血功能,尤为关键。本研究观察卡前列素氨丁三醇联合垂体后叶素对产后出血患者凝血功能及不良反应的影响,为产后出血患者临床治疗提供新思路。方法选取2018-04-03-2019-03-27汝阳县人民医院收治的102例产后出血患者为研究对象,按照年龄、孕周和分娩方式等因素组间匹配的原则分为两组,各51例。对照组给予垂体后叶素治疗,在此基础上,观察组联合卡前列素氨丁三醇治疗。观察两组疗效、凝血功能及不良反应。结果观察组治疗总有效率为96.23%,高于对照组的84.31%,差异有统计学意义,χ~2=3.991,P=0.046。治疗后,观察组凝血活酶时间为(39.68±13.71)s,低于对照组的(49.57±11.64)s,t=3.927,P<0.001;观察组纤维蛋白原为(3.24±0.62)g/mL,低于对照组的(4.02±0.84)g/mL,t=5.335,P<0.001;观察组凝血酶时间为(19.24±3.65)s,低于对照组的(25.34±5.34)s,t=6.735,P<0.001。两组不良反应发生率比较,差异无统计学意义,χ~2=0.065,P=0.799。结论卡前列素氨丁三醇联合垂体后叶素可有效改善产后出血患者凝血功能,提高产后止血效果,且联合用药未增加不良反应风险,具有一定的安全性。

OBJECTIVE Postpartum hemorrhage is the main cause of maternal death in perinatal period,which seriously threatens maternal life safety.Postpartum uterine inertia is the main reason for inducing postpartum hemorrhage.It is particularly important to timely promote uterine contraction for patients with postpartum hemorrhage in order to reduce the postpartum hemorrhage volume and improve the coagulation function.This study aims to observe the effect of carboprost tromethamine combined with pituitrin on coagulation function and adverse reactions in patients with postpartum hemorrhage,so as to provide a new idea for the clinical treatment of postpartum hemorrhage patients.METHODS A total of 102 patients with postpartum hemorrhage who admitted in Ruyang County People’s Hospital from April 3,2018 to March 27,2019 were selected as research subjects.All selected cases were divided into two groups according to the age,gestational weeks and delivery modes,with 51 cases in each group.Control group was given pituitrin,and observation group was treated with carboprost tromethamine based on control group.The efficacy,coagulation function and adverse reactions in two groups were observed.RESULTS The total effective rate of the observation group was 96.23%,higher than 84.31%of the control group,and the difference was statistically significant,χ~2=3.991,P=0.046.After treatment,the thromboplastin time,fibrinogen time and thrombin time in the observation group were(39.68±13.71)s,(3.24±0.62)g/ml and(19.24±3.65)s,respectively,lower than those in the control group(49.57±11.64)s,(4.02±0.84)g/ml and(25.34±5.34)s,with t values of 3.927,5.335 and 6.735,respectively,all P<0.001.There was no significant difference in the incidence of adverse reactions between the two groups,χ~2=0.065,P=0.799.CONCLUSION Carboprost tromethamine combined with pituitrin for patients with postpartum hemorrhage can improve coagulation function,increase postpartum hemostatic effect,and not increase risks of adverse reactions,which has certain safety.