小剂量缩宫素联合卡前列素氨丁三醇预防剖宫产高危产妇产后出血的效果评价

Effect of Low-dose Oxytocin Combined with Carboprost Tromethamine Injection on Postpartum Hemorrhage in High Risk Parturients with Cesarean Section

目的:探讨小剂量缩宫素联合卡前列素氨丁三醇(欣母沛)预防剖宫产高危产妇产后出血的临床效果。方法:选择2019年1月-2020年5月笔者所在医院收治的60例剖宫产高危产妇,均在椎管内阻滞下行剖宫产术,参照随机数字表均分为观察组和对照组。对照组静脉注射缩宫素20 U,宫体注射欣母沛250 μg,观察组静脉注射缩宫素5 U,宫体注射欣母沛250 μg。比较两组术中及术后24 h出血量、术前及术后24 h Hb水平、术前及术后24 h凝血功能(PT、TT、APTT),观察两组不良反应(恶心呕吐、面部潮红、胸闷、心悸等)。结果:观察组术中、术后24 h出血量均少于对照组,术后24 h Hb水平高于对照组,差异均有统计学意义(P<0.05)。术前两组PT、TT、APTT比较差异无统计学意义(P>0.05),术后24 h观察组PT、TT、APTT均低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:小剂量缩宫素联合欣母沛有效减少剖宫产高危产妇产后出血量,改善凝血功能,不影响不良反应。

Objective:To explore the clinical effect of low-dose Oxytocin combined with Carboprost Tromethamine Injection in the prevention of postpartum hemorrhage in high risk parturients with cesarean section.Method:A total of 60 pregnant women with high risk of cesarean section admitted to the author’s hospital from January 2019 to May 2020 were selected and all underwent cesarean section under spinal blockade.They were randomly divided into the observation group and the control group according to the random number table.The control group received 20 U of Oxytocin intravenously and 250 μg of Carboprost Tromethamine Injection intravenously,the observation group received 5 U of Oxytocin intravenously and 250 μg of Carboprost Tromethamine Injection intravenously.The blood loss during and 24 h after operation,Hb level before and 24 h after operation,coagulation function (PT,TT,APTT) before and 24 h after operation were compared between the two groups,and adverse reactions (nausea and vomiting,facial flushing,chest tightness,palpitation,etc.) were observed between the two groups.Result:The blood loss in the observation group was less than that in the control group during and 24 h after operation,and the Hb level was higher than that in the control group 24 h after operation,the differences were statistically significant (P<0.05).There was no significant difference in PT,TT and APTT between the two groups before operation (P>0.05).PT,TT and APTT in the observation group were all lower than those in the control group 24 h after operation,the difference was statistically significant (P<0.05).There were no significant difference in adverse reactions in two groups (P>0.05).Conclusion:Low-dose Oxytocin combined with Carboprost Tromethamine Injection can effectively reduce postpartum hemorrhage,improve coagulation function,and not affect adverse reactionsin high risk parturients with cesarean section.