卡前列素氨丁三醇联合缩宫素防治子痫前期剖宫产产妇产后出血的临床研究

Clinical Study on the Effect of Combination of Carboprost Tromethamine and Oxytocin on Postpartum Hemorrhage in Preeclampsia cesarean Section

目的探讨卡前列素氨丁三醇联合缩宫素防治子痫前期(PE)剖宫产产妇产后出血的临床价值。方法选取封丘县人民医院2020年5月至2021年10月期间收治的87例PE剖宫产产妇作为研究对象,根据随机数字表法随机分为观察组(n=45)和对照组(n=42)。其中观察组采用注射卡前列素氨丁三醇和缩宫素的联合治疗,对照组使用缩宫素治疗。观察并记录两组术后2 h、24 h、72 h出血量,止血起效时间及止血时长。比较两组患者治疗前后的血压收缩压(SBP)、血压舒张压(DBP)、心率(HR)水平和血清中纤维蛋白原(FIB)、D-二聚体(D-D)水平变化。结果观察组产后2 h、24 h、72 h的出血量均低于对照组对应时间出血量,观察组止血起效时间早于对照组止血起效时间,观察组止血时长短于对照组止血时长,差异有统计学意义(P<0.05)。治疗后两组SBP、DBP、HR水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组FIB、D-D水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论卡前列素氨丁三醇联合缩宫素治疗PE剖宫产产妇能有效减少术后出血量,改善血压情况,降低FIB、D-D的水平,且不良反应发生率低。

Objective To explore the clinical value of combination of carboprost tromethamine and oxytocin in the prevention and treatment of postpartum hemorrhage in preeclampsia(PE)cesarean section.Methods A total of 87 postpartum women undergoing PE cesarean section who were admitted from May 2020 to October 2021 were selected as the study subjects.They were randomly divided into an observation group(n=45)and a control group(n=42)using a random number table method.The observation group was treated with a combination of injection of carboprost tromethamine and oxytocin,while the control group was treated with oxytocin.The postoperative bleeding volume at 2 h,24 h and 72 h,onset time of hemostasis,and duration of hemostasis were observed and recorded.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),fibrinogen in serum(FIB)and D-dimer(D-D)were measured before and after treatment.Results The bleeding volume of the observation group at 2 hours,24 hours,and 72 hours postpartum was lower than that of the control group at the corresponding time.The hemostatic onset time of the observation group was earlier than that of the control group,and the hemostatic duration of the observation group was longer than that of the control group,with a statistically significant difference(P<0.05).After treatment,the levels of SBP,DBP,and HR in both groups were lower than before treatment,and the observation group was lower than the control group,with a statistically significant difference(P<0.05).After treatment,the levels of FIB and D-D in the two groups were lower than before treatment,and the observation group was lower than the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of carboprost tromethamine and oxytocin in the treatment of PE cesarean section can effectively reduce postoperative bleeding,improve blood pressure,lower FIB and D-D levels,and have a low incidence of adverse reactions.