卡前列素氨丁三醇注射液子宫肌层注射辅助治疗顺产后宫缩乏力型产后出血的临床观察

Clinical Observation of Uterine Intramuscular Injection of Carboprost Tromethamine Injection in the Adjuvant Treatment of Postpartum Hemorrhage Due To Uterine Inertia After Spontaneous Delivery

目的探讨卡前列素氨丁三醇注射液子宫肌层注射辅助治疗顺产后宫缩乏力型产后出血的治疗效果。方法将90例顺产后宫缩乏力型产后出血的产妇以投掷法随机分成观察组和对照组各45例,对照组采用产后出血常规治疗,观察组在对照组基础上使用卡前列素氨丁三醇注射液子宫肌层注射辅助治疗,比较两组的治疗效果。结果观察组总有效率显著高于对照组(P<0.05);观察组产后2h、24h出血量少于对照组(P<0.05)、第三产程时间短于对照组(P<0.05)、产后血红蛋白下降值小于对照组(P<0.05);观察组一氧化氮合酶(NOS)、血清一氧化氮(NO)脑钠肽水平(BNP)水平显著低于对照组(P<0.05);两组产后24h心率(HR)显著上升,平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)显著下降,且观察组产后24h MAP、SBP、DBP显著高于对照组,HR显著低于对照组(P<0.05);观察组不良反应总发生率为24.44%,显著低于对照组的44.44%(P<0.05)。结论卡前列素氨丁三醇在治疗产妇顺产后因宫缩乏力导致的产后出血方面效果较好,可缩短第三产程时间,改善产后出血情况,降低NO、NOS、BNP水平,稳定血动力学指标,且不良反应生率较低,有较高的临床应用价值。

Objective To investigate the effect of uterine intramuscular injection of carboprost tromethamine injection in the adjuvant treatment of postpartum hemorrhage due to uterine inertia after spontaneous delivery.Methods 90 parturients with postpartum hemorrhage due to uterine inertia after spontaneous delivery were randomly divided into observation group and control group,45 cases in each group.The control group was given conventional treatment for postpartum hemorrhage,and the observation group was treated with uterine intramuscular injection of carboprost tromethamine injection based on the treatment of control group.Therapeutic effects of the 2 groups were compared.Results The total response rate of observation group was significantly higher than that of the control group(P<0.05).Bleeding volume of the observation group at 2 hours and 24 hours after delivery was less than that of the control group(P<0.05),the third stage of labor was shorter than the control group(P<0.05),and postpartum decreased value of hemoglobin was lower than the control group(P<0.05).Besides,levels of nitric oxide synthase(NOS),serum nitric oxide(NO)and brain natriuretic peptide(BNP)in the observation group were significantly lower than those in the control group(P<0.05).HR(heart rate)of both groups was increased significantly,while MAP(mean arterial pressure),SBP(systolic blood pressure)and DBP(diastolic blood pressure)were significantly reduced at 24 hours after delivery.Meanwhile,MAP,SBP and DBP of the observation group at 24 hours after delivery were significantly higher than those of the control group,and HR was significantly lower than the control group(P<0.05).The total incidence of adverse reactions in the observation group was 24.44%,significantly lower than 44.44% of the control group(P<0.05).Conclusion Carboprost tromethamine is effective in the treatment of postpartum hemorrhage due to uterine inertia after spontaneous delivery.It can shorten the third stage of labor,improve postpartum hemorrhage,reduce NO,NOS and BNP levels,and stabilize hemodynamic indexes,with low incidence of adverse reactions.