卡前列素氨丁三醇注射液和米索前列醇防治宫缩乏力产后出血的效果比较

Comparison of the effects of prostaglandin tromethamine injection and misoprostol on prevention and treatment of postpartum hemorrhage due to uterine atony

目的比较卡前列素氨丁三醇注射液(欣母沛)和米索前列醇防治剖宫产宫缩乏力产后出血的临床效果。方法选取医院产科收治的具有宫缩乏力产后出血风险的剖宫产产妇126例为研究对象,随机分为观察组和对照组,每组63例。2组产妇在胎儿娩出后予以缩宫素治疗,对照组予以米索前列醇治疗,观察组予以欣母沛治疗。比较2组术中、产后2 h及产后24 h出血量;2组治疗前后凝血功能指标[血小板(PLT)计数、D-二聚体(D-dimer)及凝血四项凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)和凝血酶时间(TT)]变化;不良反应发生情况。结果观察组产妇术中、产后2 h及产后24 h出血量少于对照组(P均<0. 01);治疗后,2组血清PLT、D-dimer、FIB、APTT、PT、TT水平较治疗前均改善,且观察组血清PLT、FIB水平高于对照组,血清D-dimer、APTT、PT、TT水平低于对照组(P均<0. 01)。2组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论欣母沛与米索前列醇对剖宫产术后出血均具有较好的防治效果,且药物的临床安全性好,但欣母沛较米索前列醇更能减少出血量和改善血液高凝状态。

Objective To compare the clinical effects of carboprost tromethamine injection and misoprostol for prevention and treatment of cesarean section uterine contraction and postpartum hemorrhage. Methods A total of 126 cesarean section women with uterine contraction and postpartum hemorrhage risk were randomly divided into observation group and control group,with 63 cases in each group. Two groups of women were treated with oxytocin after delivery of the fetus. On this basis,the control group was treated with misoprostol,and the observation group was treated with carprostol tromethamine injection. Compare the amount of bleeding in the 2 groups,2 hours and 24 hours after delivery;The changes of coagulation function indexes [including PLT,D-dimer,APTT,PT,FIB and TT]before and after treatment were compared and the incidence of adverse reactions was compared. Results The amount of bleeding in the observation group was less than that in the control group( P < 0. 01). After treatment,the levels of serum PLT,D-dimer,FIB,APTT,PT and TT in the two groups were improved compared with those before treatment,and the serum PLT and FIB levels in the observation group were higher than those in the control group,serum D-dimer,APTT,PT,TT levels. Lower than the control group( P < 0. 01). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Carprostol tromethamine injection and misoprostol have good effects in preventing and treating bleeding after cesarean section,and have good safety,but carprostol tromethamine injection is more than misoprostol It can reduce the amount of bleeding and improve the hypercoagulable state of the patient’s blood.