氨甲环酸联合卡贝缩宫素对剖宫产术后PLT、FIB及Hb水平的影响

Effects of tranexamic acid combined with carbetocin on levels of PLT,FIB and Hb after cesarean section

目的 探讨氨甲环酸联合卡贝缩宫素对剖宫产术后预防产后出血的临床效果及对血小板计数(PLT)、血浆纤维蛋白原(FIB)及血红蛋白(Hb)值水平的影响。方法 选择2019年1月至2021年10月首都医科大学附属北京友谊医院平谷医院收治的86例行剖宫产手术的产妇作为研究对象,随机分为研究组和对照组。对照组产妇在胎儿安全娩出后静脉注射卡贝缩宫素100μg,研究组静脉滴注0.5g氨甲环酸联合100μg卡贝缩宫素。比较两组产妇的出血量,PLT、FIB及Hb水平以及不良反应的发生率。结果 研究组产妇术中、术后2 h以及术后24 h的出血量均显著小于对照组,差异有统计学意义(P<0.05)。术后24 h,两组产妇PLT值和Hb值较术前均显著减小,FIB值较术前显著增大,研究组产妇PLT值、FIB值以及Hb值显著大于对照组,差异有统计学意义(P<0.05)。两组产妇的不良反应发生率间比较差异无统计学意义(P>0.05)。结论 氨甲环酸联合卡贝缩宫素可有效减少剖宫产术后出血量,改善产妇凝血功能,且不增加不良反应的发生率。

Objective To investigate the effect of tranexamic acid combined with carbetocin on the prevention of postpartum hemorrhage after cesarean section and the change of platelet count(PLT),plasma fibrinogen(FIB)and hemoglobin(Hb)levels. Methods From January 2019 to October 2021,86 parturients who underwent cesarean section in Pinggu Hospital,Beijing Friendship Hospital,Capital Medical University of Beijing were selected as the objects,and they were randomly divided into the study group and the control group.The control group received intravenous injection of carbetocin 100 μg after the safe delivery of the fetus,and the study group received intravenous infusion of 0.5 g of tranexamic acid combined with 100 μg of carbetocin.The blood loss,PLT,FIB and Hb levels and the incidence of adverse reactions were compared between the two groups. Results The bleeding volume of parturient during operation,2 h and 24 h after operation in the study group were significantly lower than that in the control group(P<0.05). 24 hours after operation,the levels of PLT and Hb in the two groups of parturient were significantly decreased,the FIB was significantly increased.but the levels of PLT,FIB and Hb in the study group were significantly higher than those in the control group,and the difference were statistically significant(P<0.05). There were no significant difference in the incidence of adverse reactions between the two groups. Conclusion Tranexamic acid combined with carbetocin can effectively reduce the amount of bleeding after cesarean section and improve maternal coagulation function without increasing the incidence of adverse reactions.