氨甲环酸联合卡孕栓与缩宫素预防剖宫产产后出血的疗效评估

Assessment of Curative Effects of Tranexamic Acid Combined with Carboprost Methylate Suppository and Oxytocin on Postpartum Hemorrhage of Cesarean Section

目的 探讨氨甲环酸联合卡孕栓与缩宫素预防剖宫产产后出血的疗效。方法 选取2020年7月至2022年6月收治的100例剖宫产患者研究对象,随机平均分为观察组和对照组,每组50例。对照组采用卡孕栓及缩宫素治疗,观察组氨甲环酸联合卡孕栓及缩宫素治疗。比较2组产后出血发生率、术后出血量、子宫底下降速度、子宫收缩持续时间、恶露持续时间;术前及术后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板计数(PLT)、血浆纤维蛋白原降解产物(FDP)水平变化及不良反应发生情况。结果 观察组产后出血率低于对照组,术后2 h、24 h出血量少于对照组,子宫底下降速度大于对照组,子宫收缩持续时间长于对照组,恶露持续时间短于对照组,差异均有统计学意义(P<0.05)。术后24 h,观察组的血清PT、PLT及APTT水平均明显低于对照组,血清FIB、FDP水平明显高于对照组(P<0.05)。2组总不良反应发生情况差异无统计学意义(P>0.05)。结论 氨甲环酸联合促子宫收缩药物(卡孕栓与缩宫素)显著减少剖宫产术后出血量,降低产后出血发生率,改善凝血功能,更有利于术后恢复。

Objective To investigate the effects of tranexamic acid combined with carboprost methylate suppository and oxytocin on postpartum hemorrhage of cesarean section.Methods A total of 100 pregnant women with cesarean section in our hospital from July 2020 to June 2022 were selected and randomly divided into study group(50 cases) and control group(50 cases).Pregnant women in the control group were treated with carboprost methylate suppository and oxytocin,while those in the study group were treated with tranexamic acid combined with carboprost methylate suppository and oxytocin.The incidence of postpartum hemorrhage,amount of vaginal bleeding,duration of uterine contraction,descent speed of uterus fundus,and duration of lochia were compared.Changes of prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen levels(FIB),platelet count(PLT) and plasma fibrinogen degradation product(FDP) before and 24h after operation were compared.Adverse reactions were compared between the two groups.Results The incidence of postpartum hemorrhage in the study group was significantly lower than that of control group(P<0.05).The amount of vaginal blood in 2h and 24h after operation in the study group was significantly less than that of control group(P<0.05).The descent speed of uterus fundus was significantly faster than that in control group(P<0.05).The duration of uterine contraction in the study group was significantly longer than that in control group.The duration of lochia in the study group was significantly shorter than that in routine group(all P<0.05).At 24h postpartum,PT,PLT and APTT in the study group were significantly shorter than those of control group;while FIB and FDP were significantly higher(all P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion The treatment with tranexami cacid combined with carboprost methylate suppository and oxytocin can significantly prevent postpartum hemorrhage after cesarean section,lower the incidence of postpartum hemorrhage,improve coagulation function,and promote postpartum recovery of patients.