卡前列素氨丁三醇联合缩宫素在宫缩乏力性产后出血中的应用效果

Application Effect of Carprost Tromethamine Combined with Oxytocin in Postpartum Hemorrhage Caused by Uterine Contraction

目的探讨卡前列素氨丁三醇联合缩宫素在宫缩乏力性产后出血中的应用效果。方法随机选取2015年6月—2016年6月该院收治的宫缩乏力性产后出血患者110例展开分析,随机将之分为两组,对照组55例患者使用缩宫素治疗,观察组55例患者使用卡前列素氨丁三醇联合缩宫素治疗,比较分析两组凝血功能指标、氧化应激指标变化、产后出血量及不良反应发生情况。结果治疗前两组活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)及纤维蛋白原(FIB)等凝血功能指标水平对比差异无统计学意义(P>0.05),治疗后观察组各指标分别为(41.95±3.67)s、(20.54±3.42)s、(3.11±0.39)g/mL,较对照组(47.81±4.08)s、(25.38±3.86)s、(3.93±0.58)g/mL明显更低,差异有统计学意义(t=7.919、6.960、8.701,P<0.05);治疗前两组血清中肾上腺素(E)、去甲肾上腺素(NE)、醛固酮(ALD)等应激反应指标对比差异无统计学意义(P>0.05),治疗后观察组各指标分别为(147.63±14.89)ng/mL、(125.84±15.37)ng/mL、(143.73±19.82)pg/mL,较对照组(193.52±22.67)ng/mL、(157.62±17.54)ng/mL、(185.44±20.67)pg/mL明显更低,差异有统计学意义(t=12.548、10.106、10.802,P<0.05);观察组产后2 h出血量、产后24 h出血量分别为(407.43±28.51)mL、(539.86±51.72)mL,与对照组(472.49±34.37)mL、(628.93±63.89)mL相比显著更低,差异有统计学意义(t=10.805、8.036,P<0.05);观察组不良反应发生率为12.73%,与对照组7.27%相比差异无统计学意义(χ^(2)=0.909,P>0.05)。结论临床在宫缩乏力性产后出血治疗中采用卡前列素氨丁三醇联合缩宫素有助于提高止血效果,促进患者凝血功能改善,减轻机体应激反应,减少产后出血量,而且安全性高。

Objective To explore the effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage caused by uterine asthenia.Methods A total of 110 patients with postpartum hemorrhage due to uterine contraction were randomly selected from in the hospital June 2015 to June 2016 for analysis,and they were randomly divided into two groups.55 patients in the control group were treated with oxytocin and 55 patients in the observation group with carboprost tromethamine combined with oxytocin was used to compare and analyze the changes of coagulation function indexes,oxidative stress indexes,postpartum hemorrhage and adverse reactions between the two groups.Results There was no statistically significant difference in the levels of coagulation function indexes such as activated partial thromboplastin time(APTT),plasma thrombin time(TT)and fibrinogen(FIB)between the two groups before treatment(P>0.05),and the observation group after treatment of the indicators were(41.95±3.67)s,(20.54±3.42)s,(3.11±0.39)g/mL,compared with the control group(47.81±4.08)s,(25.38±3.86)s,(3.93±0.58)g/mL,was significantly lower,the difference was statistically significant(t=7.919,6.960,8.701,P<0.05);before treatment,there was no statistically significant comparison of stress response indicators such as epinephrine(E),norepinephrine(NE)and aldosterone(ALD)in the two groups before treatment(P>0.05).After treatment,the indicators of the observation group were(147.63±14.89)ng/mL,(125.84±15.37)ng/mL,(143.73±19.82)pg/mL,compared with the control group(193.52±22.67)ng/mL,(157.62±17.54)ng/mL,(185.44±20.67)pg/mL were significantly lower,the difference was statistically significant(t=12.548,10.106,10.802,P<0.05);the amount of bleeding in the observation group 2 h after delivery and 24 h after delivery were respectively(407.43±28.51)mL and(539.86±51.72)mL,which were significantly lower than those in the control group(472.49±34.37)mL and(628.93±63.89)mL,the difference was statistically significant(t=10.805,8.036,P<0.05);the incidence of adverse reactions was 12.73%,which was no statistically significant difference compared with 7.27%in the control group(χ^(2)=0.909,P>0.05).Conclusion The clinical use of carprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage caused by uterine attenuation can help improve the hemostatic effect,promote the improvement of the patient's blood coagulation function,reduce the body's stress response,and reduce the amount of postpartum hemorrhage,with high safety and worthy of promotion.