高压氧在子宫切口妊娠术后出血中的应用及其对凝血功能的影响  

Hyperbaric oxygen as an auxiliary treatment of bleeding after curettage in cesarean scar pregnancy patients and its influence on blood coagulation function

作　　者：蒿业红 朱晓黎[1] Hao Yehong;Zhu Xiaoli(Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院影像介入科,江苏省苏州215006 [2]浙江萧山医院超声科

出　　处：《中华航海医学与高气压医学杂志》2020年第5期581-584,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的研究高压氧辅助治疗在子宫切口妊娠术后出血中的应用,并分析其对凝血功能的影响。方法选取2016年1月至2018年12月浙江萧山医院妇科收治的68例子宫切口妊娠患者作为研究对象,随机数字表法分为对照组和观察组,每组34例。对照组患者给予聚桂醇局部硬化后行清宫取胚术,观察组在对照组基础上联合高压氧辅助治疗,比较2组患者术后出血、凝血功能及D-二聚体变化,同时比较2组患者不良反应发生情况。结果对照组和观察组患者术后48 h内出血量分别为(37.24±4.51)ml和(34.13±4.04)ml,差异无统计学意义(P>0.05)。治疗后,2组患者凝血功能均有改善,且观察组患者纤维蛋白原(fibrinogen,FIB)及D-二聚体水平较对照组升高,凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、抗凝血酶(antithrombin,AT)水平及人绒毛膜促性腺激素(β-hCG)则明显降低,差异均有统计学意义(P<0.05)。观察组患者发生头晕头痛1例(2.94%)、恶心呕吐2例(5.88%)、腹痛1例(2.94%)、发热0例,不良反应发生率均低于对照组,其中头晕头痛不良反应发生率差异有统计学意义(P<0.05)。结论高压氧辅助治疗能显著增加子宫切口妊娠患者FIB及D-二聚体水平,降低PT、APTT及AT水平,有效改善凝血功能,有助于预防术后出血,同时减少不良反应的发生。Objective To investigate the application of hyperbaric oxygen treatment in bleeding after curettage in cesarean scar pregnancy patients and to analyze its influence on blood coagulation function.Methods A total of 68 patients with cesarean scar pregnancy admitted to the Department of Gynecology of ZheJiang XiaoShan Hospital from January 2016 to December 2018 were selected as the research objects and randomly divided into control group(n=34)and observation group(n=34).The patients of the control group were given lauromacrogol sclerotherapy for curettage,and the observation group was given hyperbaric oxygen treatment on the basis of the treatment in the control group.The postoperative bleeding of patients,blood coagulation function,and D-dimer changes,as well as the adverse reactions were compared between the two groups.Results The amount of postoperative blooding within 48 h in the control group and the observation group were(37.24±4.51)ml and(34.13±4.04)ml,respectively,with no statistically significant difference(P>0.05).After treatment,the blood coagulation function of both groups improved,and the fibrinogen(FIB)and D-dimer levels of the patients in the observation group were significantly higher than those in the control group.However,prothrombin time(PT),activated partial thromboplastin time(APTT),antithrombin(AT)level,and human chorionic gonadotropin(β-hCG)were significantly reduced with statistically significant differences(P<0.05).There was 1 patient with dizziness headache(2.94%),2 patients with nausea and vomiting(5.88%),1 patient with abdominal pain(2.94%),and no patient with fever in the observation group,and the occurrence of adverse reactions was lower than that of the control group.The difference between the two groups regarding the occurrence of dizziness and headache was statistically significant(P<0.05).Conclusion Hyperbaric oxygen treatment can significantly increase the FIB and D-dimmer levels of patients with cesarean scar pregnancy,reduce their PT,APTT and AT,and effectively improve the blo

关 键 词：高压氧 子宫切口妊娠 出血 凝血功能 

分 类 号：R714.22[医药卫生—妇产科学]