卡前列素氨丁三醇联合缩宫素对剖宫产产后出血的疗效及对氧化应激凝血功能的影响

Effect of Carboprost Tromethamine combined with Oxytocin on Postpartum Hemorrhage after Cesarean Section and its Influence on Oxidative Stress and Coagulation Function

目的:探讨卡前列素氨丁三醇联合缩宫素对剖宫产产后出血的疗效及对氧化应激、凝血功能的影响。方法:选择2014年12月至2017年12月我院接诊的130例行剖宫产的产妇作为研究对象,通过随机数表法分为观察组(n=65)和对照组(n=65),在胎儿娩出后,对照组给予缩宫素治疗,观察组联合卡前列氨丁三醇治疗。比较两组产后出血情况、宫缩持续时间、子宫底下降速度、恶露持续时间、应激指标、凝血功能和不良反应。结果:观察组产后2h、24h出血量明显比对照组少,观察组产后出血率为6.15%(4/65),也明显低于对照组的18.46%(12/65)(P<0.05);观察组宫缩持续时间更长,子宫底下降速度明显更快,恶露持续时间明显更短,和对照组比较均具有显著差异(P<0.05);观察组在手术结束即刻、术后24h时,丙二醛(MDA)均明显低于对照组,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)、过氧化氢酶(CAT)均明显比对照组高(P<0.05);观察组在手术结束即刻、术后24h时,纤维蛋白原(FBI)、D-二聚体(D-D)均明显比对照组低(P<0.05);两组面部潮红、恶心呕吐、头痛、胸闷发生率均无显著差异(P>0.05)。结论:在剖宫产中使用卡前列素氨丁三醇联合缩宫素在预防产后出血中效果显著,且有助于缓解围术期应激反应、改善凝血功能,用药安全性高,值得应用推广。

Objective： To study the effect of carboprost tromethamine combined with oxytocin on postpartum hemorrhage after cesarean section and effects on, and oxidative stress and coagulation function. Methods： 130 patients of cesarean section who received therapy from December 2014 to December 2017 in our hospital were selected as research objects, according to random number table, those patients were divided into theobservation group （n = 65） and the control group （n = 65）, after the birth of the fetus, the control group wastreated with oxytocin, while the observation group was combined with Carboprost Tromethamine. The postpartum hemorrhage, duration of uterine contraction, duration of uterine fundus, lochia duration, stress index, coagulation function and adverse reaction were compared between the two groups. Results： The bleeding volume of 2h and 24h in the observation group was significantly less than that of the control group, the postpartumhemorrhage rate in the observation group was 6.15% （4 / 65）, which was also significantly lower than that inthe control group 18.46% （12 / 65） （P 〈0.05）, the observation group had longer uterine contraction, fasterdescending rate of uterine fundus, and shorter duration of lochia, compared with the control group, there weresignificant differences （P〈 0.05）, at the end of operation and at after operation 24h, the malondialdehyde（MDA） in the observation group was significantly lower than that of the control group, and superoxide dismutase （SOD）, glutathione peroxidase （GSH-px） and catalase （CAT） were significantly higher than that ofthe control group（P〈0.05）, at the end of operation and at after operation 24h, the fibrinogen （FBI）, D- twopolymer （D-D） in the observation group was significantly lower than that of the control group （ P 〈0.05）,there were no significant differences in facial flushing, nausea, vomiting, headache and chest tightness between the two groups（P〉0.05）. Conclusion： Carboprost tromethamine combined with oxytocin is well for prevention of postpartum hemorrhage in caesarean section, it ＇s helpful for relieving perioperative stress reactionand improve blood coagulation function, and has high safety, it＇s worthy of application and promotion.