宫腔水囊压迫法联合卡前列素氨丁三醇在产后出血患者中的疗效观察

Therapeutic effect observation of uterine water sac compression method combined with carboprost tromethamine in patients with postpartum hemorrhage

目的探讨宫腔水囊压迫法联合卡前列素氨丁三醇在产后出血患者中的治疗效果。方法选取2018年4月至2020年1月在遵义医科大学第五附属医院分娩并接受治疗的产后出血患者74例作为研究对象,采用随机数字表法将其随机分为两组,每组各37例。对照组采用宫腔纱条填塞联合宫缩素治疗,观察组采用宫腔水囊压迫法联合卡前列素氨丁三醇治疗,比较两组治疗后7天的应激反应及炎症因子水平、并发症及预后情况。结果治疗前两组应激反应及炎症因子水平无显著统计学差异(P>0.05)。观察组治疗后7天脂质过氧化物(LPO)水平显著低于对照组(t=4.465,P<0.05),超氧化物歧化酶(SOD)及谷胱甘肽过氧化物酶(GSH-Px)水平显著高于对照组(t=7.245、10.01,P<0.05)。观察组治疗后7天的C反应蛋白(CRP)、白细胞介素6(IL-6)、血清内皮素(ET)及一氧化氮(NO)水平均显著低于对照组(t=7.222、6.887、4.465,P<0.05)。两组治疗后出血性休克、头晕恶心及发热的发生率无统计差异(P>0.05)。观察组治疗后止血成功率显著高于对照组(χ^(2)=6.732,P<0.05),且子宫切除率显著低于对照组(χ^(2)=5.093,P<0.05)。结论宫腔水囊压迫法联合卡前列素氨丁三醇能改善产后出血患者应激反应及炎症因子水平,可获得良好的治疗预后,未增加并发症发生率,值得推广应用。

Objective To investigate the therapeutic effect of uterine water sac compression method combined with carboprost tromethamine in patients with postpartum hemorrhage.Methods A total of 74 patients with postpartum hemorrhage,who delivered and were treated in the Fifth Affiliated Hospital of Zunyi Medical University from April 2018 to January 2020,were selected as research objects.They were divided into two groups by random numbers table,and there were 37 cases in each group.The control group was treated with intrauterine gauze packing combined with oxytocin,and the observation group was treated with uterine water sac compression method combined with carboprost tromethamine.The levels of stress reaction and inflammatory factors at 7 days after treatment,complications and prognosis were compared between two groups.Results The differences of the levels of stress reaction and inflammatory factors before treatment between two groups were not statistically significant(P>0.05).The level of lipid hydroperoxide(LPO)at 7 days after treatment in the observation group was lower than that of the control group(t=4.465,P<0.05).The levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were higher than those of the control group(t=7.245 and 10.01,respectively,both P<0.05).The levels of C-reactive protein(CRP),interleukin-6(IL-6),endothelin(ET),and nitric oxide(NO)at 7 days after treatment in the observation group were lower than those in the control group(t=7.222,6.887,and 4.465,respectively,all P<0.05).The incidences of hemorrhagic shock,dizziness,nausea,and fever in the two groups after treatment were of no statistical significance(P>0.05).The success rate of hemostasis after treatment in the observation group was higher than that of the control group(χ^(2)=6.732,P<0.05),and the hysterectomy rate was lower than that of the control group(χ^(2)=5.093,P<0.05).Conclusion The uterine water sac compression method combined with carboprost tromethamine can improve the levels of stress reaction and inflammatory factors in patients with postpartum hemorrhage,and can obtain a good prognosis without increasing the incidence of complications.It is worthy of popularization and application.