卡前列素氨丁三醇联合卡贝缩宫素对前置胎盘剖宫产产后出血的疗效观察

Curative effect evaluation of carboprost tromethamine combined with carbetocin in treating postpartum hemorrhage of patients with placenta previa

目的探讨卡前列素氨丁三醇联合卡贝缩宫素对前置胎盘剖宫产产后出血的疗效。方法将2012年9月至2016年9月于北京海军总医院行剖宫产的102例前置胎盘产妇分为两组,每组51例。对照组胎儿娩出后采取传统综合治疗措施作为基础治疗,使用卡贝缩宫素促宫缩;观察组在此基础上再联合使用卡前列素氨丁三醇。对比两组患者的出血/止血情况(术中出血量、术后2 h出血量、止血时间、输血及子宫切除例数)、手术及术后情况(手术时间、住院时间、术后并发症)及临床疗效指标。结果观察组临床疗效、术中出血量、术后2 h出血量、止血时间、手术时间、住院时间等均优于对照组(P<0.05);血液生化指标(白细胞计数、白介素、肿瘤坏死因子)、输血例数、子宫切除例数观察组优于对照组,但差异无统计学意义(P>0.05)。结论卡前列素氨丁三醇联合卡贝缩宫素对前置胎盘剖宫产产后出血具有较为确切的疗效。

Objective To investigate the curative effect of carboprost tromethamine combined with carbetocin in treating postpartum hemorrhage of patients with placenta previa. Methods 102 patients with placenta previa in Beifing Navy General Hospital from September 2012 to September 2016 were divided into two groups, each with 51 cases. Control group received basic surgery treatment and the intervention of carbetocin, observation group received the former treatment as well, combined with carboprost tromethaminc ; Conditions including hemorrhage/hemostasis （ intraoperative bleeding, 2 h bleeding postoperative, time of hcmostasis, blood transfusion and hysterectomy cases ）, surgery and postoperative general condition （operation time, hospitalization time, postoperative complication cases） and clinical curative effect were compared between the two groups. Results The clinical efficacy, intraoperative bleeding, 2 h bleeding postoperative, time of hemostasis, operation time, hospitalization time of the observation group were significantly better than those of the control group （ P 〈 0.05 ） ; The the observation group showed better results in WBC, inflammatory factors （ IL - 6 and TNF - α） , blood transfusion and hysterectomy cases, but there were no significant differences （ P 〉 0. 05）. Conclusion The efficacy of carboprost tromethamine combined with carbetocin in treating postpartum hemorrhage of patients with placenta previa is accurate.