影响卡前列素氨丁三醇联合缩宫素治疗宫缩乏力性产后出血临床效果的因素分析

Analysis of factors influencing clinical effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage due to uterine inertia

目的 分析影响卡前列素氨丁三醇联合缩宫素治疗宫缩乏力性产后出血临床效果的因素。方法 选择2018年1月至2021年10月本院收治的197例宫缩乏力性产后出血患者作为研究对象,评价其临床效果,并以此将患者分为有效组和无效组。采用单因素分析及多因素Logistic回归分析探讨影响卡前列素氨丁三醇联合缩宫素治疗宫缩乏力性产后出血临床效果的因素。结果 197例患者中,显效79例,占比40.10%;有效82例,占比41.62%;无效36例,占比18.27%,治疗总有效率为81.73%(161/197)。单因素分析结果显示,无效组年龄>35岁、合并妊娠期高血压、合并妊娠期贫血、合并子宫肌瘤、胎盘异常、瘢痕子宫、羊水过多、产前伴发焦虑症占比及新生儿体重高于有效组,孕次多于有效组,胎儿娩出时子宫平滑肌收缩幅度、收缩频率、收缩活动力及治疗前血小板聚集率、血钙水平低于有效组,治疗前凝血酶原时间长于有效组(P<0.05)。多因素Logistic回归分析结果显示,年龄、合并妊娠期贫血、产前伴发焦虑症、治疗前凝血酶原时间为影响卡前列素氨丁三醇联合缩宫素治疗宫缩乏力性产后出血临床效果的危险因素,胎儿娩出时子宫平滑肌收缩幅度、收缩频率、收缩活动力和治疗前血小板聚集率、血钙为影响卡前列素氨丁三醇联合缩宫素治疗宫缩乏力性产后出血临床效果的保护因素(P<0.05)。结论 年龄较高、合并妊娠期贫血、产前伴发焦虑症、治疗前凝血酶原时间较长及胎儿娩出时子宫平滑肌自发性收缩能力、治疗前血小板聚集率、血钙水平下降可对卡前列素氨丁三醇联合缩宫素治疗宫缩乏力性产后出血的临床效果造成不利影响。

Objective To analyze the factors influencing clinical effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage due to uterine inertia.Methods A total of 197 patients with postpartum hemorrhage due to uterine inertia admitted in our hospital from January 2018 to October 2021 were selected as the research objects,and the clinical effect was evaluated.Based on this,the patients were divided into effective group and ineffective group.Univariate analysis and multivariate Logistic regression analysis were used to explore the factors influencing clinical effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage due to uterine inertia.Results Among 197patients,79 cases were markedly effective,accounting for 40.10%;82 cases were effective,accounting for 41.62%;36 cases were ineffective,accounting for 18.27%,and the total effective rate of treatment was 81.73%(161/197).Univariate analysis results showed that the proportions with age > 35 years old,combined with gestational hypertension,combined with gestational anemia,combined with uterine fibroids,placental abnormalities,scar uterus,polyhydramnios,prenatal anxiety and neonatal weight in the ineffective group were higher than those in the effective group,the gravidity was more than that in the effective group,the contraction amplitude,contraction frequency and contraction activity of uterine smooth muscle during fetal delivery and platelet aggregation rate and serum calcium level before treatment were lower than those in the effective group,and the prothrombin time before treatment was longer than that in the effective group(P <0.05).Multivariate Logistic regression analysis results showed that age,combined with gestational anemia,prenatal anxiety and prothrombin time before treatment were the risk factors influencing clinical effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage due to uterine inertia,the contraction amplitude,contraction frequency and contraction activity of uterine smooth muscle during fetal delivery and platelet aggregation rate and serum calcium before treatment were protective factors influencing clinical effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage due to uterine inertia(P<0.05).Conclusion The clinical effect of carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage due to uterine inertia may be adversely affected by older,combined with gestational anemia,prenatal anxiety,long prothrombin time before treatment and low spontaneous contraction ability of uterine smooth muscle during fetal delivery,platelet aggregation rate and serum calcium level.