卡前列素氨丁三醇联合宫腔球囊放置术对前置胎盘产后出血的有效性及对凝血功能的影响

Effects of caprost amine triol combined with uterine balloon placement on postpartum placenta previa hemorrhage and coagulation function

目的探讨卡前列素氨丁三醇联合宫腔球囊放置术对前置胎盘产后出血的有效性及对凝血功能的影响。方法选择2019年5月至2021年9月甘肃省妇幼保健院产一科收治的前置胎盘产后出血患者110例,根据止血方式分为观察组(n=56)和对照组(n=54)。对照组给予宫腔球囊放置术,观察组在对照组基础上加用卡前列素氨丁三醇。比较两组临床疗效、凝血功能、手术指标、宫缩持续时间、宫底下降速度、恶露持续时间及不良反应发生情况。结果治疗后,观察组总有效率高于对照组(94.64%vs 70.37%),差异有统计学意义(P<0.05)。产后两组凝血酶原时间、活化部分凝血活酶时间及凝血酶时间均显著升高,观察组低于对照组(P<0.05);两组纤维蛋白原降低,观察组高于对照组(P<0.05)。观察组手术时间、术中出血量、术后出血量及住院时间均低于对照组(P<0.05)。观察组宫缩持续时间、宫底下降速度大于对照组,恶露持续时间少于对照组(P<0.05)。观察组不良反应总发生率低于对照组(3.57%vs 16.67%),差异有统计学意义(P<0.05)。结论卡前列素氨丁三醇联合宫腔球囊放置术对前置胎盘性产后出血患者效果显著,能一定程度改善凝血功能。

Objective To investigate the effect of caprost amine triol combined with uterine balloon placement on postpartum placenta previa hemorrhage and coagulation function.Methods A total of 110 patients with postpartum placenta previa hemorrhage admitted to department of obstetrics,Gansu provincial maternal and child health hospital from May 2019 to September 2021 were selected and divided into observation group(n=56)and control group(n=54)according to hemostasis methods.The control group was given uterine balloon placement,and the observation group was given caprost amine triol on the basis of the control group.The clinical efficacy,coagulation function,surgical indexes,duration of contractions,descending speed of fundus,duration of lochia and occurrence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate of observation group was higher than control group(94.64%vs 70.37%),the difference was statistically significant(P<0.05).Postpartum prothrombin time,activated partial thrombin time and thrombin time of two groups were significantly increased,and observation group was lower than the control group(P<0.05).Fibrinogen decreased in both groups,and the observation group was higher than the control group(P<0.05).The operation time,intraoperative blood loss,postoperative blood loss and hospital stay in the observation group were lower than those in the control group(P<0.05).The duration of contractions and the descending speed of fundus in the observation group were higher than those in the control group,while the duration of lochia was lower than that of the control group(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(3.57%vs 16.67%),and the difference was statistically significant(P<0.05).Conclusion Caprost amine triol combined with uterine balloon placement is effective in patients with placental previa postpartum hemorrhage,and can improve coagulation function in a certain extent.