氨甲环酸联合卡贝缩宫素对中央性前置胎盘剖宫产妇产后出血的预防效果及对血流动力学的影响

Preventive Effect of Tranexamic Acid Combined with Oxytocin on Postpartum Hemorrhage and Effect on Hemodynamics in Patients with Central Placenta Previa Cesarean Section

目的:探究氨甲环酸联合卡贝缩宫素对中央性前置胎盘剖宫产妇产后出血的预防效果及对血流动力学的影响。方法:选取2018年1月~2019年12月本院收治的80例中央性前置胎盘产妇作为研究对象,随机分为对照组和观察组,每组40例。比较两组术后(2、24 h)出血量及产后出血发生率、术前及术后24 h血流动力学[心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)]、凝血功能[血小板计数(PLT)、血浆纤维蛋白原(FIB)、D-二聚体(D-D)]水平。结果:观察组术后2、24 h出血量均少于对照组(P <0.05),且观察组产后出血发生率(2.50%)低于对照组(16.00%,P <0.05)。术后24 h,两组HR均增加,SBP、DBP、MAP均降低(P <0.05),且观察组上述血流动力学指标改变程度均小于对照组(P <0.05)。术后24 h,观察组PLT、FIB、D-D水平均高于对照组(P <0.05)。治疗期间,两组不良反应总发生率比较无统计学差异(P> 0.05)。结论:氨甲环酸联合卡贝缩宫素对中央性前置胎盘剖宫产产妇产后出血预防效果良好,可降低产后出血发生率,维持血流动力学稳定,改善凝血功能,且安全性好。

Objective:To investigate tranexamic acid combined with oxytocin on the preventive effect and hemodynamic in postpartum patients undergoing cesarean section with central placenta previa.Methods:80 patients with central placenta previa treated in our hospital from January 2018 to December 2019 were selected as subjects.They were randomly divided into control group(n=40)and observation group(n=40).The postoperative(2 h and 24 h)blood loss,the incidence of postpartum hemorrhage,hemodynamics[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)]before and 24 hours after operation,coagulation function[platelet count(PLT),plasma fibrinogen(FIB),D-dimer(D-D)]were compared between two groups.Results:The amount of bleeding in 2 hours and 24 hours after operation in observation group was less than those in control group(P<0.05).The incidence of postpartum hemorrhage in observation group(2.50%)was less than that in control group(16.00%,P<0.05).24 hours after operation,HR increased and SBP,DBP and MAP decreased in both groups(P<0.05),with less changes in the hemodynamic indexes found in observation group than in control group(P<0.05).24 hours after operation,the levels of PLT,FIB and D-D in observation group were higher than those in control group(P<0.05).During the treatment,there was no significant difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion:Tranexamic acid combined with oxytocin is effective in the prevention of postpartum hemorrhage in patients undergoing cesarean section with central placenta previa,which can reduce the incidence of postpartum hemorrhage,maintain hemodynamic stability,improve blood coagulation,and with high safty.