不同给药方案对剖宫产术后出血产妇的心率及血压影响

Effects of therapeutic regimen on the heart rate and blood pressure in puerpera with hemorrhage after cesarean section

目的探讨剖宫产术后出血患者经不同给药方案治疗后收缩压（SBP）、舒张压（DBP）、心率（HR）变化及临床意义。方法选取我院2015年1～12月行子宫下段剖宫产术的60例足月妊娠孕妇，按给药治疗方式不同分为对照组和观察组各30例。其中对照组患者使用缩宫素宫体注射治疗，观察组患者行卡前列素氨丁三醇宫体注射治疗。观察两组患者给药后10min较给药前SBP、DBP、HR的变化情况以及产中、产后2h和产后24h的出血量及不良反应发生率。结果两组患者用药10min后与用药前相比，SBP、DBP及HR均明显升高，差异有统计学意义（P〈0．05）。与对照组比较，观察组患者SBP、DBP及HR升高更为显著，差异有统计学意义（P〈0．05）。两组患者出血量比较．观察组患者于产中、产后2h及产后24h出血量均显著低于对照组，差异有统计学意义（P〈0．05）。两组患者的不良反应情况比较差异无统计学意义（P〉0．05）。结论卡前列素氨丁三醇治疗剖宫产术后出血可积极改善患者SBP、DBP及HR等生理指标，减少产后出血量，具有积极的临床意义。

Objective To explore the effects of different therapeutic regimens on the systolic blood pressue （SBP）, diastolic blood pressure （DBP）, and heart rate （HR） in the patients with hemorrhage after cesarean section and their clinical significance. Methods 60 full-term pregnant women who were given lower segmental cesarean section in our hospital from January to December 2015 were selected. They were assigned to the control group and the observation group according to the therapeutic regimens, with 30 patients in each group. The control group was given oxytocin injected into uterine, and the observation group was given carboprost tromethamine injected into uterine. Changes of SBP, DBP and HR 10 rain after the administration in the two groups were compared with those before the administration, amount of bleeding during delivery, 2 h after delivery and 24 h after delivery as well as the incidence rate of adverse reactions were observed. Results SBP, DBP and HR were both significantly increased 10 min after the administration in the two groups compared with those before the administration, and the differences were statistically significant （P〈0.05）. Compared with the control group, the increase of SBP, DBP and HR was more significant in the observation group, and the differences were statistically significant（P〈0.05）. The amount of bleeding was compared between the two groups, and the amount of bleeding in the observation group during delivery, 2 h after delivery and 24 h after delivery were all significantly lower than those in the control group, and the differences were statistically significant（P〈0.05）. The differences of drug adverse reactions compared between the two groups were not statistically significant（P〉0.05）. Conclusion Carboprost tromethamine in the treatment of hemorrhage after Cesarean section is able to positively improve physiological indicators such as SBP, DBP and HR, and reduce amount of postpartum bleeding, which is of positive clinical significance.