注射益母草注射液、卡前列素氨丁三醇对剖宫产产妇产后出血的预防效果以及不良反应观察

Observation of preventive effect and adverse reactions of motherwort injection and carboprost tromethamine on postpartum hemorrhage in cesarean section women

目的探究注射益母草注射液、卡前列素氨丁三醇对剖宫产产妇产后出血的预防效果以及不良反应发生情况。方法前瞻性选取2020年1月至2022年3月在海南现代妇女儿童医院接收的剖宫产产妇114例,采用随机数字表法分为观察组(n=57)和对照组(n=57)。其中观察组产妇注射益母草注射液、卡前列素氨丁三醇,对照组产妇注射缩宫素。记录2组产妇:术中、术后2 h、术后24 h的出血量;术后1、3、5 h的子宫下降程度;产后2、24 h血红蛋白、红细胞计数(RBC)水平;给药前、给药第3天血清B型钠尿肽(BNP)、一氧化氮、D-二聚体表达水平;治疗后不良反应的发生情况。结果观察组产妇术中、术后2 h、术后24 h的出血量为(145.65±40.18)、(251.65±49.67)、(320.04±29.61)mL,低于对照组[(168.00±34.86)、(283.26±39.11)、(370.28±31.55)mL],产后1、3、5 h子宫下降幅度为(2.29±0.48)、(4.83±0.71)、(6.70±0.58)cm,大于对照组[(1.95±0.23)、(3.01±0.52)、(4.68±0.93)cm],产后24 h血红蛋白、RBC水平为(127.07±8.65)g/L、(4.27±0.61)×10^(12)/L,高于对照组[(120.00±12.40)g/L、(3.59±1.37)×10^(12)/L],差异均有统计学意义(P<0.05)。给药第3天,观察组血清BNP、一氧化氮、D-二聚体浓度为(86.01±15.32)pg/mL、(83.90±14.06)μmol/L、(1.95±0.28)mg/L,均低于对照组[(104.28±20.68)pg/mL、(91.28±12.00)μmol/L、(3.20±0.51)mg/L],差异均有统计学意义(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论剖宫产产妇产后注射益母草注射液以及卡前列素氨丁三醇,相较于缩宫素而言可显著降低产后出血量,改善患者的凝血功能,且具有一定的安全性。

Objective To investigate the preventive effect of motherwort injection and carboprost tromethamine on postpartum hemorrhage in cesarean section women and the occurrence of adverse reactions.Methods A total of 114 cesarean section women received in Hainan Modern Women and Children’s Hospital from January 2020 to March 2022 were prospectively selected,and divided into observation group(n=57)and control group(n=57)by random number table method.The observation group was injected with motherwort injection and carboprost tromethamine,while the control group was injected with oxytocin.The amount of bleeding during operation,2 hours after operation and 24 hours after operation;the degree of uterine decline at 1,3,5 h after operation;hemoglobin and red blood cell count(RBC)levels at 2 and 24 h postpartum;the expression levels of serum B-type natriuretic peptide(BNP),nitric oxide and D-dimer before and on the third day of administration in both groups were recorded.Results The amount of bleeding in the observation group were(145.65±40.18),(251.65±49.67),(320.04±29.61)mL,which were lower than those in the control group[(168.00±34.86),(283.26±39.11),(370.28±31.55)mL]during the operation,2 hours after the operation,and 24 hours after the operation,the uterine decline at 1,3,and 5 hours after the operation was(2.29±0.48),(4.83±0.71),(6.70±0.58)cm,which were greater than those in the control group[(1.95±0.23),(3.01±0.52),and(4.68±0.93)cm],the levels of hemoglobin and RBC at 24 h postpartum were(127.07±8.65)g/L,(4.27±0.61)×10^(12)/L,which were higher than those in the control group[(120.00±12.40)g/L,(3.59±1.37)×10^(12)/L],the differences were statistically significant(P<0.05).On the third day of administration,the concentrations of serum BNP,nitric oxide and D-dimer in the observation group were(86.01±15.32)pg/mL,(83.90±14.06)μmol/L,(1.95±0.28)mg/L,which were lower than those in the control group[(104.28±20.68)pg/mL,(91.28±12.00)μmol/L,(3.20±0.51)mg/L],the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with oxytocin,postpartum injection of motherwort injection and carboprost tromethamine can significantly reduce postpartum hemorrhage and improve the coagulation function of patients with cesarean section,and it has certain safety.