冷沉淀凝血因子联合新鲜冰冻血浆治疗宫缩乏力性产后出血患者的效果

Effects of cryoprecipitated coagulation factor combined with fresh frozen plasma in treatment of patients with postpartum hemorrhage due to uterine inertia

目的:探讨冷沉淀凝血因子联合新鲜冰冻血浆治疗宫缩乏力性产后出血患者的效果。方法:回顾性分析2018年2月至2023年1月该院收治的66例宫缩乏力性产后出血患者的临床资料,根据治疗方法不同将其分为对照组和观察组各33例。两组均予以注射缩宫素、宫腔填塞纱布等常规治疗,在此基础上,对照组输注普通冰冻血浆10~15 mL/kg,观察组在对照组基础上输注冷沉淀凝血因子10 U。比较两组临床疗效,止血时间,输血后2、6 h阴道出血量,治疗前后血流动力学指标[心率、平均动脉压(MAP)]、凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]水平,以及不良反应发生率。结果:观察组总有效率为93.94%(31/33),高于对照组的75.76%(25/33),差异有统计学意义(P<0.05);观察组止血时间短于对照组,输血后2、6 h阴道出血量均少于对照组,差异有统计学意义(P<0.05);治疗后,观察组MAP、FIB水平均高于对照组,心率、PT、TT值均低于对照组,差异有统计学意义(P<0.05);两组均未发生明显不良反应。结论:冷沉淀凝血因子联合新鲜冰冻血浆治疗宫缩乏力性产后出血患者效果显著,可缩短止血时间,减少阴道出血量,促进患者血压、心率及凝血功能恢复正常,效果优于单纯输注新鲜冰冻血浆。

Objective:To investigate effects of cryoprecipitated coagulation factor combined with fresh frozen plasma in treatment of patients with postpartum hemorrhage due to uterine inertia.Methods:The clinical data of 66 patients with postpartum hemorrhage due to uterine inertia admitted to the hospital from February 2018 to January 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,33 cases in each.Both groups were given routine treatment such as injection of oxytocin and intrauterine packing gauze.On this basis,the control group was infused with ordinary frozen plasma 10-15 mL/kg,while the observation group was infused with cryoprecipitated coagulation factor 10 U on the basis of that of the control group.The clinical efficacy,the hemostasis time,the vaginal bleeding volume 2 and 6 h after blood transfusion,the hemodynamic indexes[heart rate,mean arterial pressure(MAP)]levels,the coagulation indexes[prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)]levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 93.94%(31/33),which was higher than 75.76%(25/33)of the control group,and the difference was statistically significant(P<0.05).The hemostasis time of the observation group was shorter than that of the control group,the vaginal bleeding volume 2 and 6 h after blood transfusion was less than that of the control group,and the differences were statistically significant(P<0.05).2 h after blood transfusion treatment,the levels of MAP and FIB in the observation group were higher than those in the control group,the heart rate,PT and TT values were lower than those in the control group,and the differences were statistically significant(P<0.05).No obvious adverse reactions occurred in the two groups.Conclusions:Cryoprecipitated coagulation factor combined with fresh frozen plasma in the treatment of the patients with postpartum hemorrhage due to uterine inertia is significantly effective,which can shorten the hemostasis time,reduce the amount of bleeding,and promote the recovery of blood pressure,heart rate and coagulation function.Moreover,it is superior to single infusion of fresh frozen plasma.