卡前列素氨丁三醇联合卡贝缩宫素在剖宫产产后出血中的应用价值

Application Value of Carboprost Tromethamine Combined with Carbetocin in Postpartum Hemorrhage after Cesarean Section

目的探究卡前列素氨丁三醇联合卡贝缩宫素对剖宫产产后出血患者凝血功能、纤维蛋白降解产物(fibrin degradation products,FDP)水平的影响。方法回顾性分析2018年4月-2020年3月于连云港市妇幼保健院产科剖宫产后出血的产妇100例,根据治疗方法分为对照组和观察组,各50例。对照组患者给予缩宫素+益母草+卡前列素氨丁三醇治疗,观察组患者则给予缩宫素+益母草+卡前列素氨丁三醇+卡贝缩宫素治疗,统计并分析两组患者治疗后凝血功能、FDP水平的变化。结果①观察组的临床总有效率高于对照组(94.00%vs 78.00%),差异有统计学意义(χ^(2)=5.316,P=0.021);两组不良反应发生率(8.00%vs 6.00%),差异无统计学意义(χ^(2)=0.000,P=1.000);②观察组患者的Hb下降值、术中出血量及产后24 h累计出血量低于对照组,差异有统计学意义(P<0.05);③观察组患者的FIB水平升高,FDP水平降低,差异有统计学意义(P<0.05),但两组PT、APTT、TT差异无统计学意义(P>0.05)。结论卡前列素氨丁三醇联合卡贝缩宫素可减少产后出血产妇的出血量,减少FDP水平,从而改善产后出血产妇的凝血指标,提高临床疗效,且安全性较高。

Objective To investigate the effect of carboprost tromethamine combined with carbetocin on coagulation function and Fibrin Degradation Products(FDP)levels in patients with post-cesarean hemorrhage.Methods A retrospective analysis was performed on 100 puerperae with post-cesarean hemorrhage in the obstetrics department of Lianyungang Maternal and Child Health Hospital from April 2018 to March 2020.According to the treatment method,they were divided into control group and observation group,with 50 cases in each group.The patients in the control group were treated with oxytocin+motherwort+carboprost tromethamine.The patients in the observation group were given oxytocin+motherwort+carboprost tromethamine+carbetocin.The changes of coagulation function and FDP level in the two groups after treatment were statistically and analyzed.Results 1.the total clinical effective rate of patients in the observation group was higher than that in the control group(94.00%vs 78.00%),the difference was statistically significant(χ^(2)=5.316,P=0.021).There was no statistically significant difference in the incidence of adverse reactions between the two groups(8.00%vs 6.00%)(χ^(2)=0.000,P=1.000).2.The decreased Hb value,intraoperative blood loss and cumulative blood loss 24 h after delivery in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).3.The level of FIB in the observation group was increased,and the level of FDP was decreased,the difference was statistically significant(P<0.05).But the difference of the PT,APTT and TT between the two groups was not statistically significant(P>0.05).Conclusion Carboprost tromethamine combined with carbetocin can reduce the amount of bleeding and the level of FDP in women with postpartum hemorrhage.Thereby,the blood coagulation index of puerperae with postpartum hemorrhage can be improved,the clinical efficacy is improved,and the safety is high.