卡前列素氨丁三醇对剖宫产术患者血钙、D-二聚体水平的影响及产后出血的防治效果

Effect of Carboprost Tromethamine on Serum Calcium and D-dimer Levels in Treatment of Patients with Cesarean Section and Prevention of Postpartum Hemorrhage

目的探讨卡前列素氨丁三醇对剖宫产术后患者的血钙、D-二聚体水平的影响及对出血的防治效果。方法选择2013年10月—2015年2月解放军202医院收治的90例剖宫产术后患者,按照随机数字表法均分为观察组和对照组。对照组采用缩宫素静脉注射,观察组采用缩宫素静脉注射联合卡前列素氨丁三醇子宫壁内注射。比较两组止血效果,剖宫产术中及术后2、24 h出血量,产后出血发生率,血钙、D-二聚体水平变化。结果观察组止血总有效率显著高于对照组(P<0.05),观察组术中及术后2、24 h出血量明显低于对照组(P<0.01),产后出血发生率明显低于对照组(P<0.01);治疗后两组血钙均升高、D-二聚体水平均下降(P<0.01),观察组改善水平优于对照组(P<0.01)。结论缩宫素联合卡前列素氨丁三醇治疗剖宫产术后出血,可促进宫缩,控制出血量,升高血钙水平,降低D-二聚体水平,显著提高止血效果。

Objective To investigate the effect of Carboprost Tromethamine on serum calcium and D-dimer levels in treatment of patients with cesarean section and prevention of postpartum hemorrhage. Methods A total of 90 postoperative patients with cesarean section during October 2013 and February 2015 were divided into observation group （n = 45 ） and the control group （ n = 45） according to random number table method. The control group was given intravenous injection with Oxytoein, while observation group was injected with Oxytocin combined with Carboprost Tromethamine into uterine wall. The hemostasis effect, bleeding volumes during and 2^nd h and 24th h after the cesarean section, incidence rate of postpartum hemorrhage, changes of serum calcium and D-dimer levels were compared in the two groups. Results Compared with those in the control group, in the observation group, the total effective rate was higher （P 〈 0. 05 ） ; bleeding volumes during and 2＂d h and 24＇h h after the cesarean section were less （P 〈 0.01 ） ; incidence rate of postpartum hemorrhage was lower （P 〈 0.01 ）. After the treatment, the levels of serum calcium were increased, while D-dimer levels were decreased in the two groups （ P 〈 0.01 ） , and the improvement levels in the observation group were superior to those in the control group （P 〈 0. 01 ）. Conclusion The Oxytocin combined with Carboprost Tromethamine in treatment of postoperative bleeding of patients with cesarean section can promote uterine contraction, reduce bleeding volume, in- crease serum calcium level, decrease D-direct level and significantly improve the hemostasis efficacy.