缩宫素联合卡前列素氨丁三醇对产后出血患者凝血功能及血流动力学的影响

The Effect of Oxytocin Combined with Carboprost Tromethamine on Blood Coagulation Function and Hemodynamics in Patients with Postpartum Hemorrhage

目的:探讨缩宫素联合卡前列素氨丁三醇对产后出血患者凝血功能及血流动力学的影响。方法:选取我院于2014年1月-2017年4月期间收治的产后出血患者126例,根据乱数表法分为对照组(n=63)与研究组(n=63),其中对照组给予缩宫素治疗,研究组则给予缩宫素联合卡前列素氨丁三醇治疗。观察并比较两组患者产后出血情况、凝血功能以及血流动力学各项指标,同时观察两组患者的生活质量及不良反应发生情况。结果:研究组患者产后出血发生率、产后2 h出血量以及产后24 h出血量均明显低于对照组(P<0.05)。两组患者活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、血浆凝血酶时间(TT)、纤维蛋白原(Fg)相比无统计学差异(P>0.05)。治疗2 h后两组患者心率(HR)较治疗前升高,且对照组高于研究组,收缩压(SBP)、舒张压(DBP)较治疗前降低,且对照组低于研究组(P<0.05);治疗24 h后研究组患者SBP高于对照组(P<0.05);两组患者不同时间的血氧饱和度(SPO_2)比较均无统计学差异(P>0.05)。研究组患者的躯体功能、精神健康、情感职能、社会活动以及社会功能得分均高于对照组(P<0.05)。对照组患者不良反应发生率为7.94%,与研究组的6.35%比较无统计学差异(P>0.05)。结论:缩宫素联合卡前列素氨丁三醇可有效减少患者产后出血发生率,维持患者血流动力学稳定,对患者凝血功能无影响,生活质量评分较高,值得临床推广。

Objective： To studythe effect of oxytocin combined with carboprost tromethamine on blood coagulation function and hemodynam-ics in patients with postpartum hemorrhage. Methods： 126 cases of postpartum hemorrhage admitted in our hospital from January 2014 to April 2017 were selected. The patients were divided into the control group（n=63） and the research group（n=63） according to random number table method, the control group was treated with oxytocin, the study group was treated with oxytocin combined with carboprost tromethamine. The conditions of postpartum hemorrhage, blood coagulation and hemodynamics of two groups were observed and compared, at the same time, at the same time, the quality of life and the incidence of adverse reactions were observed in the two groups of patients. Results： The incidence of postpartum hemorrhage, the amount of postpartum 2 h bleeding and postpartum 24 h bleeding after postpartum in the research groupwere significantly lower than that in the control group（P〈0.05）. There was no significant difference in activated partial thromboplastin time（APTT）, prothrombin time（PT）, thrombin time（TT）, fibrinogen（Fg）between the two groups（P〈0.05）. After treatment for 2 h, the heart rate（HR） of the two groups was higher than that before treatment, and the control group was higher than the research group, the systolic pressure（SBP） and diastolic pressure（DBP） were lower than those before treatment, and the control group was lower than the research group（P〈0.05）. The SBP in the research group after treatment for 24 h was higher than that of the control group（P〈0.05）. There was no significant difference in blood oxygen saturation（SPO2） between the two groups at different time（P〉0.05）. The scores of physical function, mental health, emotional function, social activities and social function in the research group were significantly higher than those in the control group（P〈0.05）. The incidence of adverse reactions in the control group was 7.94%, and there was no significant difference compared with the 6.35% in the research group（P〉0.05）. Conclusion： Oxytocin combined with romethamine can effectively reduce the incidence of postpartum hemorrhage, maintain maternal hemodynamic stability, and have no influence on maternal coagulation function, high quality of life score, which is worthy of clinical promotion.