卡贝缩宫素与欣母沛预防剖宫产高危产妇产后出血效果及对凝血功能的影响

The Effect of Carbetocin and Hemabate on the Postpartum Hemorrhage of High-risk Parturients of Cesarean Section and Its Effect on the Function of Blood Coagulation

目的:比较卡贝缩宫素与欣母沛预防剖宫产高危产妇产后出血效果及对凝血功能的影响。方法:选取2017年6月-2018年6月于笔者所在医院接受治疗的202例剖宫产高危产妇为受试对象,按照入院编号随机分为试验组与对照组,各101例。对照组予以卡贝缩宫素治疗,试验组使用欣母沛进行治疗。比较两组产妇产后出血情况(产后2、24 h内出血量及产后出血发生率)、泌乳功能指标(产后泌乳初始时间、产后24、48 h泌乳量评分)及术前、产后24 h凝血功能指标,包括凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT),以及用药后不良反应发生情况。结果:试验组产后2、24 h出血量均少于对照组,差异均有统计学意义(P<0.05),两组产后出血发生率比较差异无统计学意义(P>0.05);试验组产后泌乳初始时间短于对照组,产后24、48 h泌乳量评分均高于对照组,差异均有统计学意义(P<0.05);产后24 h两组PT、APTT、FIB、TT水平与术前比较差异无统计学意义(P>0.05),且两组间比较差异无统计学意义(P>0.05);试验组产妇不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:与卡贝缩宫素比较,欣母沛更能改善剖宫产高危产妇产后出血情况,对产妇凝血功能及泌乳功能均无影响,且不良反应发生率低,安全性高。

Objective:To compare the effect of Carbetocin and Hemabate on the postpartum Hemorrhage of high-risk parturients at high risk of cesarean section and its effect on the function of blood coagulation.Method:A total of 202 high-risk parturients of cesarean section who were treated in our hospital from June 2017 to June 2018 were selected as subjects and randomly divided into the experimental group and the control group according to admission number,101 cases in each group.The control group was treated with Carbetocin,while the experimental group was treated with Hemabate.The postpartum hemorrhage(2,24 h postpartum bleeding volume and postpartum hemorrhage incidence),lactation function indexes(postpartum lactation initial time,24,48 h postpartum lactation score)and coagulation function indexes before and 24 h after delivery,including prothrombin time(PT),activated partial prothrombin time(APTT),prothrombin(FIB),thrombin time(TT),and adverse reactions after treatment were compared between the two groups.Result:The blood loss of 2,24 hours after delivery in the experimental group were less than that of the control group(P<0.05).There was no significant difference in the incidence of postpartum hemorrhage between the two groups(P>0.05).The initial time of postpartum lactation in the experimental group was shorter than that in the control group,and the scores of postpartum lactation in the experimental group were significantly higher than those in the control group at 24 and 48 hours after delivery(P<0.05).There were no significant differences in PT,APTT,FIB,TT level between the two groups at 24 h postpartum compared with those before operation(P>0.05),and there were no significant differences between the two groups(P>0.05).The total incidence of adverse reactions in the experimental group was lower than that in the control group(P<0.05).Conclusion:Compared with Carbetocin,Hemabate can better improve the postpartum hemorrhage of high-risk parturients in cesarean section.It has no effect on the coagulation and lactation function of parturients,and the incidence of adverse reactions is low and the safety is high.