卡列前素氨丁三醇注射液治疗产后出血患者临床结局的影响研究

Effect of the carboprost trometamole injection on clinical outcome of patients with postpartum hemorrhage

目的:探究卡列前素氨丁三醇注射液治疗产后出血患者临床结局的影响。方法:选取我院在2014年2月至2015年2月期间收治的产后出血患者140例作为该研究的研究对象,按照随机数表法将这140例患者随机分为观察组70例和对照组70例。给予对照组患者常规治疗,给予观察组患者行卡列前素氨丁三醇注射液治疗,对比两组患者治疗疗效、产后出血情况、凝血功能指标以及不良反应情况。结果:观察组显效占比44.3%(31/70),有效率为97.1(68/70),均显著高于对照组的25.7%(18/70)、88.6%(62/70),P值均小于0.05,差异均有统计学意义。对照组患者第三产程时间(5.6±1.8)min、产后2h出血量(468.2±175.6)m L、产后24h出血量(533.2±201.6)m L、产后出血发生率22.9%、产后24h血红蛋白下降值(16.8±3.7)g/L明显高于观察组(3.1±1.2)min、产后2h出血量(321.8±112.7)m L、产后24h出血量(374.8±141.7)m L、产后出血发生率5.7%、产后24h血红蛋白下降值(11.2±2.6)g/L,P值均小于0.05,差异有统计学意义。观察组患者APTT(30.2±7.2)s、PT(13.2±5.2)s、TT(18.2±4.7)s、Fg(4.7±1.3)g/L和对照组相比(31.3±7.1)s、PT(12.8±5.1)s、TT(17.9±4.8)s、Fg(4.8±1.3)g/L凝血功能指标相当(P>0.05),观察组腹泻、血压升高、恶心、面色潮红等不良反应情况与对照组相当(P>0.05)。结论:卡前列素氨丁三醇起效快,作用时间长,可以有效降低产妇产后出血时间和出血量,明显缩短产妇第三产程,安全性高,值得在临床推广。

Objectives： To explore the effect of the carboprost trometamole injection on clinical outcome of patients with postpartum hemorrhage. Methods： 140 patients with postpartum hemorrhage in our hospital from February 2014 to 2015 February were selected and randomly divided into observation group（ 70 cases） and control group（ 70 cases）. Control group received routine treatment. Observation group received carboprost trometamole injection treatment. Curative effect,postpartum hemorrhage,blood coagulation indexes and adverse reactions of two groups were compared. Results： In observation group,the significant effect rate accounted for 44. 3%（ 31/70） and effective rate was 97. 1%（ 68/70）,which were significantly higher than theses in control group of 25. 7%（ 18/70）and 88. 6%（ 62/70） respectively,（ P〈0. 05）. In control group,the third labor time was（ 5. 6 ± 1. 8） min,2h postpartum hemorrhage volume was（ 468. 2 ± 175. 6） ml,24 h postpartum hemorrhage volume was（ 533. 2 ±201. 6） ml,postpartum hemorrhage incidence was 22. 9% and 24 h postpartum hemoglobin value decreased（ 16. 8± 3. 7） g/L,which were significantly higher than these in observation group,i. e. third labor time（ 3. 1 ± 1. 2）min,2h postpartum hemorrhage volume（ 321. 8 ± 112. 7） ml,24 h postpartum hemorrhage（ 37. 48 ± 14. 17）ml,postpartum hemorrhage incidence 5. 7%,24 h postpartum hemoglobin decrease value（ 11. 2 ± 2. 6） g/L. The differences were statistically significant,（ P〈0. 05）. Coagulation indexes of observation group were APTT（ 30. 2± 7. 2） s,Pt（ 13. 2 ± 5. 2） s,TT（ 18. 2 ± 4. 7） s and FG（ 4. 7 ± 1. 3） g/L and coagulation indexes of control group were APTT（ 31. 3 ± 7. 1） s,Pt（ 12. 8 ± 5. 1） s,TT（ 17. 9 ± 4. 8） s and FG（ 4. 8 ± 1. 3） g/L. The differences were not significant（ P〉0. 05）. Differences in adverse reactions between observation group and control group,such as diarrhea,blood pressure elevation,nausea and flushing,were not significant（ P〉0. 05）.Conclusion： The effect of carboprost trometamole injection is fast,with long therapeutic effect. It can effectively reduce the postpartum hemorrhage time and amount of bleeding,and shorten the third labor process,with high safety,which is worthy of clinical promotion.