卡前列素氨丁三醇注射液联合卡贝缩宫素治疗子宫收缩乏力性产后出血患者的效果

Efficacy of Carboprost Tromethamine Injection Combined with Carbetocin in the Treatment of Patients with Postpartum Hemorrhage Caused by Uterine Atony

目的评价卡前列素氨丁三醇注射液联合卡贝缩宫素治疗子宫收缩乏力性产后出血(PPH)的临床效果。方法选取2020年1月-2022年6月于余干县妇幼保健院分娩并出现子宫收缩乏力性PPH的60例产妇,依照随机数字表法分为对照组(30例)与观察组(30例),对照组给予卡贝缩宫素治疗,观察组在其基础上应用卡前列素氨丁三醇注射液治疗,比较两组止血总有效率、产后出血量、血常规[血红蛋白(Hb)、红细胞压积(HCT)]、产后恢复情况(宫缩持续时间、宫底下降速度、恶露持续时间)、不良反应发生率。结果观察组止血有效率为96.67%,高于对照组的83.33%(P<0.05)。两组治疗后24 h出血量少于治疗前,且观察组治疗后24 h出血量少于对照组(P<0.05)。两组治疗后Hb、HCT指标均高于治疗前,且观察组Hb、HCT指标高于对照组(P<0.05)。观察组宫缩持续时间、恶露持续时间短于对照组,且宫底下降速度大于对照组(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注射液联合卡贝缩宫素治疗子宫收缩乏力性PPH的效果肯定,可有效减少产妇的产后出血量,促进其血常规恢复,缩短产后恢复时间,且不增加不良反应发生风险。

Objective To evaluate the clinical effect of carboprost tromethamine injection combined with carbetocin in the treatment of patients with postpartum hemorrhage(PPH)caused by uterine atony.Methods From January 2020 to June 2022,60 parturients who gave birth to PPH with uterine atony in Yugan County Maternal and Child Health Hospital were selected and divided into control group(30 parturients)and observation group(30 parturients)according to the random number table method.The control group was treated with carbetocin,and the observation group was treated with carboprost tromethamine injection on the basis of the control group.The total effective rate of hemostasis,postpartum hemorrhage,blood routine[hemoglobin(Hb),hematocrit(HCT)],postpartum recovery(duration of uterine contraction,rate of uterine fundus decline,duration of lochia)and incidence of adverse reactions were compared between the two groups.Results The effective rate of hemostasis in the observation group was 96.67%,which was higher than 83.33%in the control group(P<0.05).The amount of bleeding at 24 h after treatment in the two groups was less than that before treatment,and the amount of bleeding at 24 h after treatment in the observation group was less than that in the control group(P<0.05).The Hb and HCT indexes of the two groups after treatment were higher than those before treatment,and the Hb and HCT indexes of the observation group were higher than those of the control group(P<0.05).The duration of uterine contraction and lochia in the observation group were shorter than those in the control group,and the descending rate of fundus was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Carboprost tromethamine injection combined with carbetocin is effective in the treatment of PPH due to uterine atony.It can effectively reduce the amount of postpartum hemorrhage,promote the recovery of blood routine,shorten the time of postpartum recovery,and do not increase the risk of adverse reactions.