卡前列素氨丁三醇联合缩宫素和米索前列醇预防产后出血的效果分析

Effect of carboprost tromethamine combined with oxytocin and misoprostol in prevention of postpartum hemorrhage

目的探究卡前列素氨丁三醇联合缩宫素和米索前列醇预防产后出血的效果及安全性。方法观察性研究。抽取2021年1月至2023年1月于平顶山市第一人民医院分娩的产妇85例,按照入院先后顺序随机分为对照组(42例)和研究组(43例)。对照组予以缩宫素和米索前列醇预防产后出血,研究组予以缩宫素、米索前列醇及卡前列素氨丁三醇预防产后出血。比较两组产妇的临床疗效、产后出血情况、住院时长、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)]及药物相关不良反应发生率。结果研究组治疗总有效率(93.02%,40/43)高于对照组(76.19%,32/42),P<0.05。研究组产后出血发生率(2.33%,1/43)低于对照组(16.67%,7/42),产后2、24、48 h出血量少于对照组,产后出血总时长及住院时长短于对照组(P<0.05)。治疗后,两组APTT、TT、FIB水平均低于治疗前,且研究组低于对照组(P<0.05)。两组产妇药物相关不良反应发生率比较差异未见统计学意义(P>0.05)。结论卡前列素氨丁三醇联合缩宫素和米索前列醇可明显减少产后出血发生率,减少出血量,缩短出血时长,且安全性高。

Objective To investigate the efficacy and safety of carboprost tromethamine combined with oxytocin and misoprostol in the prevention of postpartum hemorrhage.Methods Eighty-five pregnant women who delivered in Pingdingshan No.1 People’s Hospital from January 2021 to January 2023 were selected for the observational study.And they were randomly divided into a control group(42 cases)and a study group(43 cases)according to the order of admission.The control group was treated with oxytocin and misoprostol to prevent postpartum hemorrhage,and the study group was treated with oxytocin,misoprostol and carboprost tromethamine to prevent postpartum hemorrhage.The clinical efficacy,postpartum hemorrhage,length of hospital stay,coagulation function,including activated partial thromboplastin time(APTT),thrombin time(TT)and fibrinogen(FIB),and incidence of drug-related adverse reactions were compared between the two groups.Results The total effective rate of the study group(93.02%,40/43)was higher than that of the control group(76.19%,32/42),P<0.05.The incidence of postpartum hemorrhage in the study group(2.33%,1/43)was lower than that in the control group(16.67%,7/42),P<0.05.The study group had less postpartum bleeding at 2,24,and 48 hours after delivery compared with the control group,while the total duration of postpartum bleeding and hospitalization were longer than those of the control group(P<0.05).After treatment,the levels of APTT,TT,and FIB in both groups were lower than those before treatment,and the indexes in the study group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of drug-related adverse reactions between the two groups(P>0.05).Conclusions Carboprost tromethamine combined with oxytocin and misoprostol can reduce the incidence of postpartum hemorrhage,decrease the amount of bleeding,and shorten bleeding duration,with high safety.