卡贝缩宫素对高危产妇剖宫产术中及术后影响的研究

Effect of Carbetocin on the Operation and Postoperative Cesarean Section of High-risk Women

目的:评价卡贝缩宫素对高危产妇剖宫产术中及术后出血的预防效果及凝血功能的变化。方法:回顾性分析医院2016年10月至2019年10月收治的70例剖宫产高危产妇的临床资料,依据患者接受治疗的方案不同,将其分为卡贝组和缩宫素组,各35例,比较两组患者在手术用药后2 h及手术用药后24 h的出血情况、第三产程时间、血红蛋白水平、血压、心率;产妇分娩后不同时间段凝血功能指标:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及不良反应发生率。结果:在出血量及出血率方面,卡贝组产妇剖宫术后用药第2h及术后用药第24小时均显著低于缩宫素组(P<0.05),两组用药后各阶段出血率差异不显著(P>0.05);在生理指标方面,术后用药第2天患者的血红蛋白水平、收缩压(SBP)、舒张压(DBP)及心率均差异不显著(P>0.05),术后用药24 h,卡贝组产妇的血红蛋白水平及收缩压(SBP)均显著高于缩宫素组(P<0.05);在凝血功能方面,除用药后24 h卡贝组的FIB显著高于缩宫素组(P<0.05)外,其余各阶段两组的凝血功能指标均差异不显著(P>0.05);卡贝组第三产程显著低于缩宫素组(P<0.05),两组不良反应总发生率差异无统计学意义(P>0.05)。结论:卡贝缩宫素可降低高危产妇剖宫产术中及术后出血量,提高其凝血功能,对保障患者术后生命安全具有重要临床应用价值。

Objective:To evaluate the preventive effect and coagulation function of carbetocin in high-risk maternal cesarean section during and after cesarean section.Methods:The clinical data of 70 high-risk cesarean delivery women admitted to the hospital from October 2016 to October 2019 were retrospectively analyzed.According to the different treatment options for patients,they were divided into Kabe group and oxytocin group.Compare the bleeding situation,the third stage of labor,hemoglobin level,blood pressure,heart rate of the two groups of patients after 2 hours of operation and 24 hours after operation.Indexes of coagulation function in different periods of time after delivery of women:prothrombin time(PT),thrombin time(APTT),fibrinogen(FIB)and incidence of adverse reactions.Results:In terms of bleeding volume and bleeding rate,the 2 h and the 24 h after the cesarean section were significantly lower than those in the oxytocin group(P<0.05).The difference in bleeding rate between the two groups after treatment was not the same.Significantly(P>0.05).In terms of physiological parameters,hemoglobin level,systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate were not significantly different(P>0.05),postoperative medication 24 h.The hemoglobin level and systolic blood pressure(SBP)of the Kabe group were significantly higher than those of the oxytocin group(P<0.05).In the coagulation function,the FIB of the Kabe group was significantly higher than that of the oxytocin group 24 h after the administration(P<0.05).The coagulation function indexes of the two groups were not significantly different(P>0.05);the third stage of the Kabe group was significantly lower than the oxytocin group(P<0.05),the total incidence of adverse reactions in the two groups.The difference was not significant(p>0.05).Conclusion:Carbetocin can reduce the amount of bleeding during and after cesarean section in high-risk women,and improve its coagulation function,which has important clinical application value for ensuring postoperative life safety.