缩宫素联合卡前列素氨丁三醇对瘢痕子宫再次剖宫产产妇产后出血的预防作用研究

Study on the preventive effect of oxytocin combined with carboprost tromethamine on postpartum hemorrhage of cesarean section women with scar uterus

目的探讨缩宫素联合卡前列素氨丁三醇对瘢痕子宫再次剖宫产产妇产后出血的预防作用。方法选择昆明市妇幼保健院2021年1月-2021年12月收治的瘢痕子宫再次剖宫产产妇82例,使用随机投掷法将其分为实验组和对照组,每组各41例,两组均行剖宫产手术,对照组术后给予缩宫素,实验组在对照组基础上联合使用卡前列素氨丁三醇,对比两组术后出血量、凝血指标、子宫收缩情况以及不良反应。结果实验组术后出血量少于对照组(P<0.05);治疗后两组FIB、D-D水平均升高,且实验组高于对照组;PT、APTT均降低,且实验组低于对照组(P<0.05);实验组子宫收缩持续时间长于对照组;且子宫底下降速度高于对照组(P<0.05);实验组与对照组不良反应发生情况无明显差异(P>0.05)。结论缩宫素联合卡前列素氨丁三醇在瘢痕子宫再次剖宫产产妇产后出血的预防中能够有效降低产后出血量,改善凝血指标、应激指标以及子宫收缩情况,药物安全性较高,值得推广。

Objective To explore the preventive effect of oxytocin combined with carboprost tromethamine on postpartum hemorrhage in women undergoing cesarean section with scar uterus.Methods 82 cases of cesarean section women with scar uterus who were admitted to our hospital from January 2021 to December 2021 were randomly divided into the experimental group and the control group with 41 cases in each group.Both groups underwent cesarean section.The control group was given oxytocin after operation.The experimental group was combined with carboprost tromethamine on the basis of the control group.The postoperative bleeding volume,coagulation index,uterine contraction and adverse reactions were compared between the two groups.Results The amount of postoperative bleeding in the experimental group was less than that in the control group(P<0.05);after treatment,the levels of FIB and D-D increased in both groups,and the experimental group was higher than the control group;PT and APTT were lower in the experimental group than in the control group(P<0.05);the duration of uterine contraction in the experimental group was longer than that in the control group;the descending speed of the uterine fundus was higher than that of the control group(P<0.05);there was no significant difference in the occurrence of adverse reactions between the experimental group and the control group(P>0.05).Conclusion Oxytocin combined with carboprost tromethamine can effectively reduce the amount of postpartum hemorrhage,improve blood coagulation index,stress index and uterine contraction in the prevention of postpartum hemorrhage in women with scar uterus undergoing cesarean section again.The drug is safe and worth promoting.