卡前列素氨丁三醇治疗高危妊娠产后出血的临床效果分析

Analysis on Clinical Effect of Carboprost Tromethamine in Treatment of High-Risk Pregnancy Postpartum Hemor⁃rhage

目的:探讨卡前列素氨丁三醇治疗高危妊娠产后出血的临床效果。方法:选取滨州医学院附属医院收治的高危妊娠产后出血患者160例(收治时间:2019年10月—2022年10月)作为研究对象,随机分为对照组、观察组,各80例。对照组采用缩宫素治疗,观察组采用卡前列素氨丁三醇治疗。比较两组血压水平、凝血功能、产后出血量、血红蛋白水平、不良反应发生率。结果:产前,两组舒张压、收缩压对比,差异无统计学意义(P>0.05);产后2 h,两组舒张压、收缩压均下降,但观察组下降幅度小于对照组(P<0.05)。产前,两组D-二聚体(D-D)水平、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平、凝血酶原时间(PT)对比,差异无统计学意义(P>0.05);产后24 h,两组D-D水平低于产前,且观察组低于对照组,两组APTT、PT短于产前,且观察组短于对照组,两组FIB水平高于产前,且观察组高于对照组,差异有统计学意义(P<0.05)。产后2、24 h,观察组出血量少于对照组,差异有统计学意义(P<0.001)。产前,两组血红蛋白水平对比,差异无统计学意义(P>0.05);产后24 h,两组血红蛋白水平低于产前,但观察组高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:卡前列素氨丁三醇治疗高危妊娠产后出血的临床效果良好,能改善患者血压水平及凝血功能,有效控制病情,减少产后出血量,改善血红蛋白水平,且安全性高。

Objective:To explore the clinical effect of carboprost tromethamine in treatment of high-risk pregnancy postpartum hemorrhage.Methods:A total of 160 patients with high-risk pregnancy postpartum hemorrhage admitted to Binzhou Medical University Hospital(from October 2019 to October 2022)were selected as the study subjects.They were randomly divided into the control group and the observation group,with 80 cases in each group.The control group was treated with oxytocin and the observation group was treated with carboprost tromethamine.Blood pressure levels,coagulation function,postpartum blood loss,hemoglobin level and incidence of adverse reactions were compared between two groups.Results:Before childbirth,there was no significant difference in diastolic blood pressure and systolic blood pressure between the two groups(P>0.05).At postpartum 2 h,diastolic blood pressure and systolic blood pressure decreased in the two groups,but the decline in the observation group was smaller than that in the control group(P<0.05).Before childbirth,there was no significant difference in D-dimer(D-D)level,activated partial prothrombin time(APTT),fibrinogen(FIB)level and prothrombin time(PT)between the two groups(P>0.05).At postpartum 24 h,the levels of D-D in the two groups were lower than those before childbirth,and the levels in the observation group were lower than those in the control group;the APTT and PT levels in the two groups were shorter than those before childbirth,and the levels in the observation group were shorter than those in the control group;the levels of FIB in the two groups were higher than those before childbirth,and the levels in the observation group were higher than those in the control group;and the difference was statistically significant(P<0.05).At postpartum 2 h and 24 h,the blood loss in the observation group was less than that in the control group,and the difference was statistically significant(P<0.001).Before childbirth,there was no significant difference in hemoglobin level between the two groups(P>0.05).At postpartum 24 h,the hemoglobin level in the two groups was lower than that before childbirth,but the level in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Carboprost tromethamine has a good clinical effect in the treatment of high-risk pregnancy postpartum hemorrhage,and can improve blood pressure levels and coagulation function of patients,effectively control the disease condition,reduce postpartum blood loss,and improve hemoglobin level,with a high safety.