卡前列素氨丁三醇不同使用时机防治宫缩乏力性产后出血的疗效及其对血流动力学的影响

Curative Effects of Carprost Tromethamine Used at Different Timing in the Prevention and Treatment of Postpartum Hemorrhage due to Uterine Inertia and the Influence on Hemodynamics

目的观察卡前列素氨丁三醇不同使用时机预防和治疗宫缩乏力性产后出血的临床疗效及其对血流动力学的影响。方法选取我院90例有宫缩乏力性产后出血倾向的产妇,分为三组各30例。A组在胎儿娩出后立即使用缩宫素及卡前列素氨丁三醇; B组在胎儿娩出后立即使用缩宫素,在达到宫缩乏力诊断时才使用卡前列素氨丁三醇; C组在胎儿娩出后立即使用缩宫素,不使用卡前列素氨丁三醇。分析比较三组产妇第三产程、产后2 h及24 h出血量,产后出血发生率及血流动力学指标。结果 A组的第三产程、产后2 h出血量及产后出血发生率均低于B组和C组(P <0.05)。B组的第三产程、产后2 h出血量及产后出血发生率均低于C组(P <0.05)。A组的产后24 h出血量低于C组(P <0.05)。A组和B组、 B组和C组的产后24 h出血量比较差异无统计学意义(P>0.05)。产前,三组的HR、 MAP水平比较差异均无统计学意义(P>0.05)。产后24 h, A组的HR、MAP水平与B组、 C组比较有统计学差异(P <0.05), B组的HR、 MAP水平与C组比较有统计学差异(P <0.05)。结论使用卡前列素氨丁三醇预防和治疗宫缩乏力性产后出血具有明显临床疗效,可改善产妇的血流动力学指标。

Objective To observe the clinical efficacy of carprost tromethamine used at different timing in the prevention and treatment of postpartum hemorrhage due to uterine inertia and the influence on hemodynamics. Methods 90 cases of puerperas with tendency of postpartum hemorrhage due to uterine inertia in our hospital were selected and divided into three groups, with 30 cases in each group. Group A used oxytocin and carprost tromethamine immediately after delivery. Group B used oxytocin immediately after delivery, and used carprost tromethamine in the diagnosis of uterine inertia. Group C used the oxytocin immediately after delivery, without using carprost tromethamine. The blood loss at the third stage of labor, 2 h and 24 h after delivery, incidence of postpartum hemorrhage, and hemodynamic indicators were analyzed and compared among the three groups. Results The blood loss at the third stage of labor and 2 h after delivery, and incindence of postpartum hemorrhage of group A were lower than those of group B and group C(P<0.05). The blood loss at the third stage of labor and 2 h after delivery, and incindence of postpartum hemorrhage of group B were lower than those of group C(P<0.05). The blood loss at 24 h after delivery of group A was lower than that of group C(P<0.05). No statistical difference was found in the blood loss at 24 h after delivery between group A and group B, also group B and group C(P>0.05). Before delivery, no statistical difference was found in the HR and MAP levels among three groups(P>0.05). 24 h after delivery, the HR and MAP levels of group A were significantly different from those of group B and group C(P<0.05), and HR and MAP levels of group B were significantly different from those of group C(P<0.05).Conclusions Carboprost tromethamine has significant clinical efficacy in the prevention and treatment of postpartum hemorrhage due to uterine inertia, and can improve the maternal hemodynamics.