卡前列氨丁三醇联合卡贝缩宫素对剖宫产术后止血效果及凝血功能的影响

Effect of Hemabate Combined with Carbetocin on Hemostasis Effect and Coagulation Function After Cesarean Section

目的探讨卡前列氨丁三醇注射液(商品名:欣母沛)联合卡贝缩宫素应用于剖宫产术后止血的临床疗效。方法将60名剖宫产产妇按照随机数字表法分为对照组和试验组,每组30例。对照组产妇剖宫产术后采用卡贝缩宫素止血;试验组产妇剖宫产术后采用欣母沛联合卡贝缩宫素止血,比较两组产妇用药前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)的指标水平;比较两组产妇去氧肾上腺素用量、低血压出血次数、尿量和止血时间;比较两组产妇手术前后的出血量。结果试验组产妇去氧肾上腺素水平、低血压出血次数、止血时间明显低于对照组;尿量明显高于对照组,差异均有统计学意义(P<0.05)。两组产妇治疗前后PT、APTT、TT、FIB指标比较,差异有统计学意义(P<0.05)。随着时间迁移,PT、APTT、TT呈现显著上升趋势,FIB呈现显著下降趋势。治疗后试验组指标PT、APTT、TT、FIB显著低于对照组;试验组产妇产后1、2、6和12h出血量显著少于对照组,差异有统计学意义(P<0.05)。结论欣母沛联合卡贝缩宫素用于产妇剖宫术后止血疗效较好,值得临床推广应用。

Objective To investigate the clinical effect of hemabate combined with carbetocin on hemostasis after cesarean section.Methods A total of 60 patients treated with cesarean section were divided into the control group and experiment group according to the random number table,and each group consisted of 30 patient.The control group was treated with oxytocin for hemostasis after cesarean section,while the experiment group was treated with hemabate combined with oxytocin for hemostasis after cesarean section.The levels of the indexes including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and fibrinogen(FIB)before and after medication were compared between the two groups.The indexes including the dosage of deoxy adrenaline,frequency of hypotensive hemorrhage,urine volume and hemostatic time were also compared between the two groups.The bleeding amount before and after operation were compared between the two groups.Results The intraoperative indexes including the dosage of deoxy adrenaline,frequency of hypotensive hemorrhage and hemostatic time were significantly less and the urine volume was significantly more in the experiment group than in the control group(P<0.05).There were significant differences in the indexes including PT,APTT,TT and FIB before and after medication between the two groups(P<0.05).Over time,the indexes including PT,APTT and TT showed significant upward trends,while FIB showed a significant downward trend.After treatment,the indexes including PT,APTT,TT and FIB in the experiment group were significantly lower than those in the control group.The bleeding amounts at 1 h,2 h,6 hand 12 hafter operation were significantly lower in the experiment group than in the control group(P<0.05).Conclusion Hemabate combined with carbetocin has better hemostasis effect in women treated with cesarean section,so it is worthy of clinical popularization and application.