卡前列素氨丁三醇用于妊娠产后出血的疗效及对纤维蛋白原与D-二聚体的影响

Curative efficacy of carboprost romethamine in treatment of postpartum hemorrhage of pregnancy and its effects on fibrinogen and D-dimer

目的探讨卡前列素氨丁三醇用于妊娠产后出血的疗效及对纤维蛋白原（FIB）与D-二聚体（D-D）的影响。方法选择2015年11月~2016年11月金华市妇幼保健院妇产科接诊的106例产后出血患者,通过随机数表法分为观察组（53例）和对照组（53例）。对照组在分娩后给予缩宫素治疗,观察组使用予卡前列素氨丁三醇治疗。比较2组术后2 h、术后24 h出血量、宫缩持续时间、恶露持续时间、子宫底下降速度以及治疗前后FIB、D-D的变化,并比较不良反应。结果观察组术后2 h、24 h出血量均明显低于对照组[（231.58±36.79）m L vs.（345.62±45.60）m L,（301.24±44.01）m L vs.（445.23±61.74）m L]（P〈0.05）;与对照组比较,观察组宫缩持续时间更长,恶露持续时间更短,子宫底下降速度更快（P〈0.05）;治疗前,2组FIB、D-D水平比较差异不明显,治疗后,对照组FIB、D-D水平未发生明显变化,观察组FIB、D-D水平均明显降低,且结果均低于对照组（P〈0.05）;2组恶心呕吐、胸闷、寒战发生率无显著差异。结论卡前列素氨丁三醇在妊娠产后出血中具有明显优势,可明显改善血液高凝状态,降低产后出血量,值得应用推广。

Objective To study curative efficacy of carboprost romethamine in treatment of postpartum hemorrhage of pregnancy and its effects on fibrinogen（FIB） and D-dimer（D-D）.Methods106 patients of chronic renal failure who received therapy from November 2015 to November 2016 in our hospital were selected.According to random number table, those patients were divided into the observation group （n=53） and the control group （n=53）.The control group was treated with oxytocin after delivery, while the observation group was treated with carboprost romethamine.The postoperative 2h and 24h bleeding volume, contraction duration, duration of lochia, uterus decreased speed and the changes of FIB and D-D before and after treatment were compared, and comparison of adverse reactions.ResultsThe postoperative 2h and 24h bleeding volume in the observation group were significantly lower than those in the control group[（231.58±36.79）mL vs （345.62±45.60）mL, （301.24±44.01）mL vs （445.23±61.74）mL] （P〈0.05）;compared with the control group, the observation group contraction duration longer, duration of lochia was shorter, uterus decreased was faster（P〈0.05）;before treatment, there was no significant difference in FIB and D-D between the two groups;after treatment, the levels of FIB and D-D in the control group did not change significantly;the levels of FIB and D-D in the observation group were significantly reduce, and the result were lower than those in the control group（P〈0.05）;there was no significant difference in the incidence of nausea and vomiting, chest pain, chills between the two groups.ConclusionCarboprost romethamine is well for postpartum hemorrhage of pregnancy, which can effectively improve blood hypercoagulable state, reduce the amount of postpartum hemorrhage, it＇s worthy of application and promotion.