卡前列氨丁三醇联合米索前列醇治疗凶险性前置胎盘产后出血

Curative efficacy of carprostol combined with misoprostolin treatment dangerous postpartum hemorrhage of placenta previa

目的探讨卡前列氨丁三醇联合米索前列醇治疗凶险性前置胎盘产后出血的疗效。方法将2018年3月~2019年3月我院收治的凶险性前置胎盘患者50例纳入本次研究行前瞻性分析,根据简单随机数表法分为观察组(n=26)和对照组(n=24)。对照组使用米索前列醇治疗,观察组在对照组的基础上加用卡前列氨丁三醇治疗。比较两组患者的临床疗效、产后出血量、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、谷胱甘肽过氧化物酶(GSH-P)、去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)水平变化情况及不良反应的发生情况。结果治疗后两组总有效率差异有统计学意义(P<0.05);观察组产后2、8、24 h出血量均显著低于对照组,差异有统计学意义(P<0.05);治疗前两组氧化应激指标水平差异无统计学意义(P>0.05),治疗后两组SOD、GSH-P水平均显著升高,且观察组均高于对照组,LPO显著下降,观察组低于对照组(P<0.05);治疗前两组应激激素水平差异无统计学意义(P>0.05),治疗后两组NE、E、Cor水平均显著升高,且观察组均显著低于对照组(P<0.05);两组不良反应总发生率差异无统计学意义(P>0.05)。结论卡前列氨丁三醇联合米索前列醇在治疗凶险性前置胎盘产后出血中效果显著,安全性较高,可供临床借鉴。

Objective To study the curative efficacy of carprostol combined with misoprostolin treatment dangerous postpartum hemorrhage of placenta previa.Methods 50 patients with dangerous placenta previa admitted to our hospital from March 2018 to March 2019 were included in this study.They were divided into observation group(n=26)and control group(n=24)according to the simple random number table method.The control group was treated with misoprostol,and the observation group was treated with carboprostol on the basis of the control group.The clinical efficacy,postpartum blood loss,oxidative stress[superoxide dismutase(SOD),lipid peroxide(LPO),glutathione peroxidase(GSH-P)],the stress hormone[norepinephrine(NE)and epinephrine(E)and cortisol(Cor)]level changes and the occurrence of adverse reactions were observed.Results After treatment,the total effective rate of the two groups was 96.15%and 75.00%,respectively,with significant difference(P<0.05).The blood loss in the observation group was significantly lower in the control group at 2h postpartum,8h postpartum and 24h postpartum(P<0.05).Before treatment,there was no significant difference in the levels of oxidative stress between the two groups.After treatment,SOD and gsh-p levels in the two groups increased significantly,and both the observation group were higher than the control group,LPO significantly decreased,and the observation group was lower than the control group(P<0.05).Before treatment,there was no significant difference in stress hormone levels between the two groups.After treatment,the levels of NE,E and Cor were significantly increased in both groups,and were significantly lower in the observation group than in the control group(P<0.05).The total incidence of adverse reactions in the two groups was 11.54%and 25.00%,with no statistically significant difference(P>0.05).Conclusion Hemabate combined with misoprostol is effective and safe in the treatment of dangerous placenta previa postpartum hemorrhage.