卡前列素氨丁三醇对剖宫产产妇凝血功能及产后出血的影响

Effect of Carboprost Tromethamine on Coagulation Function and Postpartum Hemorrhage in Parturients Underwent Cesarean Section

目的探讨卡前列素氨丁三醇对剖宫产产妇凝血功能及产后出血的影响。方法选取医院2019年6月至2020年6月收治的行剖宫产的产妇103例,按随机数字表法分为对照组(51例)和观察组(52例)。两组产妇均给予卡贝缩宫素注射液静脉滴注,观察组产妇加用卡前列素氨丁三醇注射液子宫侧壁注射。两组均持续治疗7 d。结果治疗后,观察组产妇的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间均明显短于对照组,纤维蛋白原水平明显高于对照组,超敏C反应蛋白、前列腺素E2、Toll样受体4水平均明显低于对照组(P<0.05);观察组产妇术后2,12,24 h的出血量均明显少于对照组(P<0.05)。两组产妇治疗前后平均动脉压、中心静脉压、心率无明显改变,且组间比较无明显差异(P>0.05)。观察组与对照组不良反应发生率相当(13.46%比9.80%,P>0.05)。结论卡前列素氨丁三醇用于剖宫产手术,能改善凝血功能,降低产后出血量及炎性因子水平,且不影响围术期产妇的血压及心率。

Objective To investigate the effect of carboprost tromethamine on coagulation function and postpartum hemorrhage in parturients underwent cesarean section.Methods A total of 103 parturients who underwent cesarean section in the hospital from June 2019 to June 2020 were selected and divided into the control group(51 cases)and the observation group(52 cases)according to the random number table method.The parturients in the two groups were given an intravenous infusion of Cabetoxine Injection,on this basis,the parturients in the observation group were injected with Carboprost Tromethamine Injection into the lateral wall of the uterus.Both groups were treated for 7 d.Results After treatment,the prothrombin time(PT),thrombin time(TT)and activated partial thromboplastin time(APTT)in the observation group were significantly shorter than those in the control group,while the level of fibrinogen(Fib)in the observation group was significantly higher than that in the control group(P<0.05).The levels of high sensitivity C-reactive protein(hs-CRP),prostaglandin E2(PGE2)and toll-like receptor 4(TLR4)in the observation group were significantly lower than those in the control group(P<0.05).The bleeding loss in the observation group at 2,12 and 24 h after operation was significantly less than that in the control group(P<0.05).There was no significant change in mean arterial pressure(MAP),central venous pressure(CVP)and heart rate(HR)in the two groups before and after treatment,and there was no significant difference between the two groups(P>0.05).The incidence of adverse drug reactions in the observation group was similar to that in the control group(13.46%vs.9.80%,P>0.05).Conclusion The application of carboprost tromethamine during cesarean section can improve maternal coagulation function,and reduce postpartum hemorrhage and inflammatory factor levels without affecting perioperative blood pressure and heart rate.