卡前列素氨丁三醇联合卡贝缩宫素对前置胎盘剖宫产产妇相关指标的影响

Effect of carboprost tromethamine combined with carbetocin on related indexes of placenta previa with cesarean section

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妇产后出血血流动力学及血液生化指标的影响。方法将我院产科进行剖宫产分娩的82例前置胎盘剖宫产产妇按照随机数字表法均分为观察组和对照组,对照组给予卡贝缩宫素,观察组给予卡前列素氨丁三醇联合卡贝缩宫素。观察2组产妇的手术情况、术后出血情况、术后住院时间及治疗效果,比较2组产妇产后出血、子宫切除及术后感染情况,对比术前及术后2 h 2组产妇的收缩压(SBP)、舒张压(DBP)和心率(HR),对比术前及术后24 h 2组产妇肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞(WBC)的水平。结果观察组产妇手术时间、止血时间、术中出血量、术后2 h出血量、术后24 h出血量及术后住院时间均低于对照组(P<0.05)。观察组总有效率高于对照组(P<0.05)。观察组产妇产后出血发生率低于对照组(P<0.05),2组子宫切除及术后感染情况对比差异无统计学意义。术后2 h 2组产妇的SBP和DBP均低于术前,对照组低于观察组(P<0.05),术后2 h 2组产妇的HR高于术前,且对照组高于观察组(P<0.05)。术后24 h 2组产妇的TNF-α、IL-6和WBC水平均高于术前(P<0.05),但2组比较差异无统计学意义(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防治效果较好,能降低产妇手术时间、出血量、术后住院时间及子宫切除发生率,对SBP、DBP和HR无严重影响,可进一步推广应用。

Objective To explore the influence of carboprost tromethamine combined with carbetocin on haemodynamics and blood biochemical indexes in placenta previa parturient women with postpartum hemorrhage after cesarean section.Methods 82 placenta previa parturient women who were received cesarean section delivery in obstetrics department of our hospital were divided into observation group and control group according to the random number table.The control group were treated with carbetocin,while the observation group were treated with carboprost tromethamine combined with carbetocin.The operation conditions,postoperative bleeding,postoperative hospital stay and treatment effect of parturient women in the 2 groups were observed,the postpartum hemorrhage,hysterectomy and postoperative infection in the 2 groups were compared,and the systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) in the 2 groups before operation and 2 h after operation were compared.The tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6) and white blood cell (WBC) levels in the 2 groups before operation and 24 h after operation were also compared.Results The operation time,hemostasis time,intraoperative blood loss,postoperative 2 h bleeding,postoperative 24 h bleeding and postoperative hospital stay in the observation group were all lower than those in the control group ( P <0.05).The total effective rate of the observation group were higher than that of the control group ( P <0.05).The incidence of postpartum hemorrhage in the observation group was lower than that of the control group ( P <0.05),there was no significant difference in hysterectomy and postoperative infection between the 2 groups after operation.At 2 h after operation,SBP and DBP in the 2 groups were lower than that before operation,and the control group was lower than that of the observation group ( P <0.05).At 2 h after operation,HR in the 2 groups was higher than that before operation,and the control group was higher than that of the observation group ( P <0.05).At 24 h after operation,the levels of TNF-α,IL-6 and WBC in the 2 groups were higher than those before operation ( P <0.05),but there was no significant difference between the control group and the observation group ( P >0.05).Conclusion The control effect of carboprost tromethamine combined with carbetocin on postpartum hemorrhage after cesarean section in placenta previa parturient women is good,it can reduce the operation time,blood loss,postoperative hospital stay and the incidence of hysterectomy,there is no serious effect on SBP,DBP and HR,which is worth of further popularization and application.