欣母沛联合卡贝缩宫素注射液治疗宫缩乏力性产后出血的疗效观察

Observation on the curative effect of xinmupei combined with carbetocin injection in the treatment of postpartum hemorrhage caused by uterine inertia

目的:研究欣母沛联合卡贝缩宫素注射液治疗宫缩乏力性产后出血(UAPH)的疗效。方法:选取2020年6月—2021年6月本院UAPH患者60例,按照随机数字表法分为两组,分别为单一组30例和联合组30例,单一组给予欣母沛肌肉注射,250μg/次,按照子宫反应及患者症状缓解情况,在2~3 h后重复注射250μg欣母沛,若子宫收缩力不足,可增加剂量至500μg,但每日用药总剂量需<2 mg;联合组在单一组基础上予以缩宫素注射液静脉滴注,2 g/次,1次/12 h。比较两组疗效、不同时期出血情况、血压[收缩压(SBP)、舒张压(DBP)]变化、凝血功能[凝血酶原时间(PT)、纤维蛋白原(FIB)]水平及不良反应情况。结果:联合组总有效率为96.67%(29/30),较单一组的73.33%(22/30)高(P<0.05);联合组产妇术中、术后出血量均较单一组少(P<0.05);治疗前两组DBP和SBP水平比较无显著差异(P>0.05),治疗后两组DBP和SBP水平均较治疗前升高,且联合组较单一组高(P<0.05);治疗前两组PT和FIB水平比较无显著差异(P>0.05),治疗后两组PT水平均较治疗前升高,且联合组较单一组高,两组FIB水平均较治疗前降低,且联合组较单一组低(P<0.05);两组不良反应发生率比较无显著差异(P>0.05)。结论:欣母沛联合卡贝缩宫素注射液治疗UAPH可明显减轻出血症状,并有效改善患者血压和凝血功能,临床效果显著。

Objective:To study the therapeutic effect of xinmupei combined with carbetocin injection in the treatment of uterine atony postpartum hemorrhage(UAPH).Methods:According to the random number table method,60 patients with UAPH in our hospital from June 2020 to June 2021 were selected and randomly divided into a single group and a combined group,with 30 patients in each group.The single group was given xinmupei by intramuscular injection,250μg/time.According to the uterine reaction and the patient's symptom relief,the patients in the single group repeatedly received xinmupei(250μg)injection 2 to 3 hours later.If the uterine contractility is insufficient,the dose can be increased to 500μg.However,the total daily dosage should be less than 2 mg.The combined group was given oxytocin injection by intravenous drip based on the single group,2 g/time,every 12 hours.The efficacy,bleeding in different periods,changes of blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],levels of coagulation function[prothrombin time(PT),fibrinogen(FIB)],and adverse reactions were compared between the two groups.Results:The total effective rate of the combined group was 96.67%(29/30),which was higher than that of the single group(73.33%(22/30)(P<0.05).The amount of bleeding during and after the operation in the combined group was less than that in the single group(P<0.05).Before treatment,there was no significant difference in DBP and SBP levels between the two groups(P>0.05).After treatment,the levels of DBP and SBP in the two groups were higher than those before treatment,and the combined group was higher than that in the single group(P<0.05).Before treatment,there was no significant difference in PT and FIB levels between the two groups(P>0.05).After treatment,the PT level of both groups was higher than before treatment,and the FIB level of the combined group was higher than that of the single group.The FIB level of both groups was lower than before treatment,and the combined group was lower than that of the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:xinmupei combined with carbetocin injection in treating UAPH can significantly reduce bleeding symptoms and effectively improve blood pressure and coagulation function,with significant clinical effects.