卡前列素氨丁三醇在预防高危产妇产后出血中的疗效及药物经济性探讨

Efficacy and Drug Economical Efficiency of Carboprost Tromethamine in the Prevention of Postpartum Hemorrhage in High-risk Puerperae

目的观察卡前列素氨丁三醇在预防高危产妇产后出血的疗效并分析其药物经济性。方法回顾性分析我院176例行剖宫产分娩的高危产妇临床资料,根据其术中使用产后出血防治药物分为缩宫素+卡前列素氨丁三醇组(观察组,n=90)及缩宫素+米索前列醇组(对照组,n=86)。记录两组产后出血防治效果、住院期间药物相关不良反应发生情况及成本-效果分析,比较两组术中、术后2 h、术后24 h出血量和分娩前、出院时负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]差异。结果观察组产后出血防治效果明显高于对照组(P<0.05),且住院期间药物相关不良反应总发生率和术中、术后2 h、术后24 h出血量均低于对照组(P<0.05)。两组成本比较,差异无统计学意义(P>0.05);观察组效果明显高于对照组(P<0.05),且成本效果比明显低于对照组(P<0.05)。出院时,两组负性情绪(SAS、SDS评分)均较分娩前降低(P<0.05),且观察组均低于对照组(P<0.05)。结论使用卡前列素氨丁三醇联合缩宫素防治高危产妇产后出血较米索前列醇联合缩宫素更经济,不仅具有更强的止血效果,不良反应也较少,于产妇产后身心健康恢复均有利。

Objective To observe the efficacy ofcarboprost tromethamine in the prevention of postpartum hemorrhage in high-risk puerperae and to analyze its drug economical efficiency. Methods The clinical dataof 176 cases of high-risk puerperae who underwent cesarean sectiondelivery in our hospital were retrospectively analyzed, and the patients were divided into oxytocin+carboprosttromethamine group(observation group, n=90) and oxytocin+misoprosto lgroup(control group, n=86)according to the intraoperative use of postpartum hemorrhage prevention and treatment drugs. The prevention and treatment effects of postpartum hemorrhage, occurrence of drug-related adverse reactions during hospitalization and cost-effectiveness analysis were recorded in the two groups. The hemorrhage volumes during operation and at 2 h and 24 h after operation and negative emotions before delivery and at discharge [Selfrating Anxiety Scale(SAS), Self-rating Depression Scale(SDS)] were compared between the two groups. Results The prevention and treatment effects of postpartum hemorrhage in observation group were significantly higher than those in control group(P<0.05), and the total incidence rate of drug-related adverse reactions during hospitalization and hemorrhage volumes during operation and at 2 h and 24 h after operation were lower than those in control group(P<0.05). There was no significant difference in the cost between the two groups(P >0.05). The effects in observation group were significantly higher than those in control group(P<0.05), and the cost-effectiveness ratio was significantly lower than that in control group(P<0.05). At discharge, the negative emotions(SAS, SDS scores) in the two groups were decreased compared with those before delivery(P<0.05), and the scores in observation group were lower than those in control group(P<0.05). Conclusions Carboprost tromethamine combined with oxytocin is more economical than misoprostol combined withoxytocin in the prevention of postpartum hemorrhage in high-risk puerperae. It not only has stronger hemostasis effects, but also has fewer adverse reactions, and it is beneficial to the recovery of postpartum physical and mental health of puerperae.