卡前列素氨丁三醇在剖宫产产后出血防治中的应用效果及其对血流动力学、凝血功能的影响

Application effect of carboprost tromethamine in prevention and treatment of postpartum hemorrhage in cesarean section and its effect on hemodynamics and coagulation function

目的研究卡前列素氨丁三醇在剖宫产产后出血防治中的应用效果及其对血流动力学、凝血功能的影响。方法选取94例剖宫产产妇作为研究对象,均于2016年3月至2017年5月入院,根据随机数字表法分为对照组和研究组,每组47例。对照组选用缩宫素治疗,研究组基于缩宫素选用卡前列素氨丁三醇治疗;比较两组剖宫产产妇治疗前、后血流动力学指标、凝血功能指标水平与治疗后产后出血发生率、术后2 h出血量、术后24 h出血量及不良反应发生情况。结果治疗后,两组剖宫产产妇血流动力学指标(HR、DBP及SBP)水平较治疗前更优(P<0.05);与对照组比较,研究组血流动力学指标水平更优(P<0.05)。治疗后,两组剖宫产产妇凝血功能指标(FIB、TT及APTT)显著降低,且研究组低于对照组(P<0.05)。与对照组比较,研究组治疗后产后出血发生率更低,术后2 h出血量、术后24 h出血量更少,研究组不良反应总发生率更低(P<0.05)。结论卡前列素氨丁三醇在剖宫产产后出血防治中的应用效果显著,可进一步改善产妇的血液高凝状态,使血流动力学保持稳定状态,还可减少术后出血量,降低产后出血发生率与不良反应发生率,值得推广应用。

Objective To study the application effect of carboprost tromethamine in prevention and treatment of postpartum hemorrhage in cesarean section and its effect on hemodynamics and coagulation function. Methods Ninety-four cases of parturients underwent caesarean section were selected as the objects and hospitalized from March 2016 to May2017. According to the random number table method, the parturients were divided into control group and study group, with47 cases in each group. The control group was treated with oxytocin, and the study group was treated with carboprost tromethamine based on oxytocin; the levels of hemodynamic parameters and coagulation function indexes before and after treatment, the incidence of postpartum hemorrhage after treatment, the amounts of postoperative 2, 24 h bleeding and occurrence of adverse reactions were compared between the two groups. Results After treatment, the levels of hemodynamic parameters（HR, DBP, SBP） in the two groups were better than those before treatment（P〈0.05）; compared with the control group, the levels of hemodynamic parameters in the study group were better（P〈0.05）. After treatment, the levels of coagulation function indexes（FIB, TT, APTT） in the two groups significantly decreased, and those in the study group were lower than the control group（P〈0.05）. Compared with the control group, the incidence of postpartum hemorrhage in the study group was lower, the amount of 2, 24 h bleeding after operation in the study group were less, the total incidence of adverse reactions in the study group was lower（P〈0.05）. Conclusion Carboprost tromethamine in prevention and treatment of postpartum hemorrhage in cesarean section has a significant effect. It can further improve maternal blood hypercoagulability and maintain hemodynamic stability, reduce the amount of postoperative bleeding and decrease the incidences of postpartum hemorrhage and adverse reactions. It deserves to be popularized and application.