缩宫素、米索和卡前列素氨丁三醇治疗胎盘早剥产后大出血的效果  

The Effect of Oxytocin,Misoprostol,and Carboprost Tromethamine in the Treatment of Postpartum Hemorrhage Due to Placental Abruption

作　　者：燕婷婷 张红[1] 张冉[1] YAN Tingting;ZHANG Hong;ZHANG Ran(Department of Obstetrics,Nanyang Central Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市中心医院产科,河南南阳473000

出　　处：《临床研究》2024年第10期60-63,共4页Clinical Research

摘　　要：目的 分析与讨论缩宫素、米索及卡前列素氨丁三醇应用在胎盘早剥(PA)产后大出血中的治疗效果。方法 共筛选南阳市中心医院2021年7月至2023年7月入院的88例PA产后大出血患者。应用随机数字法分组,参照组(n=44)以缩宫素与米索治疗,研究组(n=44)在参照组基础上联合米前列索氨丁三醇治疗,比较两组临床有效率、舒张压(DBP)、收缩压(SBP)、心率(HR)水平、出血量与出血时间、凝血指标[D-二聚体(D-D)、纤维蛋白原(Fbg)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)]、不良反应。结果 研究组治疗有效率高于参照组,差异有统计学意义(P <0.05)。研究组持续出血时间短于参照组,并且术中、术后10 min、60 min、2 h、24 h出血量均少于参照组,差异具有统计学意义(P <0.05)。治疗后,研究组Fbg指标高于参照组,D-D、APTT、TT、PT指标均低于参照组,差异具有统计学意义(P <0.05)。两组患者治疗前后DBP、SBP、HR水平对比差异无统计学意义(P> 0.05)。两组患者不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 联合应用缩宫素、米索、卡前列素氨丁三醇治疗PA产后大出血,可缩短止血时间,降低出血量,改善凝血功能,用药安全性高。Objective To analyze and discuss the therapeutic effect of oxytocin,misoprostol,and carboprost tromethamine in the treatment of postpartum hemorrhage due to placental abruption(PA).Methods A total of 88 patients with Postpartum hemorrhage due to PA admitted to Nanyang Central Hospital from July 2021 to July 2023 were selected.They were randomly divided into a reference group(n=44)treated with oxytocin and misoprostol,and a study group(n=44)treated with oxytocin,misoprostol,and carboprost tromethamine.The clinical efficacy,diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate(HR),blood loss and bleeding time,coagulation indicators[D-dimer(D-D),fibrinogen(Fbg),thrombin time(TT),activated partial thromboplastin time(APTT),plasma prothrombin time(PT)],and adverse reactions were compared between the two groups.Results The effective rate of treatment in the study group was higher than that in the reference group,with statistically significant differences(P<0.05).The study group had shorter bleeding duration and less blood loss intraoperatively and at 10 minutes,60 minutes,2 hours,and 24 hours postoperatively compared to the reference group,with statistically significant differences(P<0.05).After treatment,the Fbg levels in the study group were higher than those in the reference group,while the D-D,APTT,TT,and PT levels were lower than those in the reference group,with statistically significant differences(P<0.05).There were no statistically significant differences in DBP,SBP,and HR levels between the two groups before and after treatment(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combined use of oxytocin,misoprostol,and carboprost tromethamine in the treatment of Postpartum hemorrhage due to PA can shorten hemostasis time,reduce blood loss,improve coagulation function,and has high medication safety.

关 键 词：胎盘早剥 缩宫素 产后出血 米前列索氨丁三醇 米索前列醇 

分 类 号：R713.42[医药卫生—妇产科学]