卡前列素氨丁三醇应用时机对中央性前置胎盘剖宫产妇产后出血及血流动力学的影响

Effects of Application Timing of Carboporst Tromethamine on Postpartum Hemorrhage and Hemodynamics of Cesarean Section Women with Central Placenta Previa

目的:探讨卡前列素氨丁三醇应用时机对中央性前置胎盘剖宫产妇产后出血及血流动力学的影响,并评价其安全性。方法:选取2015年1-12月我院住院分娩的中央性前置胎盘产妇138例,采用随机数字表法分为观察组和对照组,各69例。两组产妇均行剖宫产术,对照组产妇胎盘娩出后子宫体注射卡前列素氨丁三醇注射液250μg,观察组产妇断脐后立即宫底注射卡前列素氨丁三醇250μg。观察两组产妇手术时间、术中及术后出血量,并比较两组产妇术前及术后24 h血流动力学指标、凝血功能,以及不良反应发生情况。结果:观察组产妇手术时间显著短于对照组,术中出血量及24 h总出血量显著少于对照组,差异均有统计学意义(P<0.05)。术前,两组产妇血流动力学指标和凝血功能指标比较,差异均无统计学意义(P>0.05);术后24 h,两组产妇收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、纤维蛋白原(FIB)、D-二聚体(D-D)显著降低,心率(HR)显著升高,且观察组显著优于对照组,差异均有统计学意义(P<0.05);两组产妇不良反应发生率比较(15.94%vs.13.04%),差异无统计学意义(P>0.05)。结论:卡前列素氨丁三醇断脐后宫底注射有助于缩短中央性前置胎盘剖宫产手术时间,减少术中出血量,维持血流动力学指标相对稳定,改善凝血功能,且安全性较好。

OBJECTIVE:To investigate the effects of application timing of carboporst tromethamine on postpartum hemorrhage and hemodynamics of cesarean section women with centralplacenta previa.METHODS:Totally138parturient women with central placenta previa selected from our hospital during Jan.-Dec.2015were divided into observation group and control group according to random number table,with69cases in each group.Both groups received cesarean section.Control group was given Carboporst tromethamine injection250μg on uterine body after the delivery of placenta.Observation group was given Carboporst tromethamine injection250μg on corpora uteri immediately after umbilical cord cutting.The operation duration,intraoperative and postoperative blood loss were observed in2groups.The preoperative and postoperative24h hemodynamic index,coagulation functionand corpora uteri were compared between2groups.RESULTS:The operation duration of observation group was significantly shorter than control group;intraoperative blood loss and24h blood loss of observation group were significantly less than controlgroup,with statistical significance(P<0.05).There was no statistical significance in preoperative hemodynamic index and coagulationfunction index between2groups before surgery(P>0.05).24h after surgery,SBP,DBP,MAP,FIB and D-D of2groups were decreased significantly,while HR of them were increased significantly;the observation group was significantly better than thecontrol group,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR(15.94%vs.13.04%)between2groups(P>0.05).CONCLUSIONS:Carboporst tromethamine after omphalotomy via uterine body helps toshorten the operation time,reduce intraoperative blood loss,maintain hemodynamic indexes stable and improve coagulation function of cesarean section women with central placenta previa,with good safety.