邱春梅

【摘要】 目的：探討卡前列素氨丁三醇联合缩宫素对预防剖宫产产妇产后出血的临床效果及凝血功能的影响。方法：以2020年4月-2021年3月在本院妇产科行剖宫产的240例产妇为研究对象。根据随机数字表法将240例产妇分为对照组和研究组，每组120例。对照组在分娩出胎儿后立刻给予缩宫素20 U静脉滴注，研究组在分娩出胎儿后立刻给予缩宫素20 U静脉滴注，同时宫肌注射卡前列素氨丁三醇250 g。比较两组出血情况、凝血功能和不良反应。结果：研究组产后2、24 h出血量均低于对照组（P<0.05）。两组术前APTT、TT、FIB和血小板计数比较，差异均无统计学意义（P>0.05）;两组术后APTT、TT、FIB和血小板计数均低于术前，且研究组均低于对照组，差异均有统计学意义（P<0.05）。研究组不良反应发生率为10.00%，低于对照组的11.67%，但两组比较差异无统计学意义（字2=0.678，P>0.05）。结论：与常规单纯应用缩宫素相比，卡前列素氨丁三醇联合缩宫素预防剖宫产产妇产后出血效果显著，能有效改善产妇凝血功能，减少产后2、24 h出血量，且安全性高。

【关键词】 卡前列素氨丁三醇 缩宫素 剖宫产 产后出血 凝血功能

Clinical Effect of Carboprost Aminobutyric Triol Combined with Oxytocin on Prevention of Postpartum Hemorrhage in Parturients Underwent Cesarean Section and Its Influence on Coagulation Function/QIU Chunmei. //Medical Innovation of China， 2021， 18（28）： -113

[Abstract] Objective： To investigate the clinical effect of Carboprost Aminobutyric Triol combined with Oxytocin on prevention of postpartum hemorrhage in parturients underwent cesarean section and its influence on coagulation function. Method： From April 2020 to March 2021， 240 cases of postpartum hemorrhage after cesarean section in obstetrics and gynecology department of our hospital were selected as the research objects. According to the random number table method， 240 cases were divided into the control group and the study group， 120 cases in each group. The control group was given Oxytocin 10 U intravenous drip immediately after delivery， while the study group was given Oxytocin 10 U intravenous drip immediately after delivery， and Carboprost Butanol 250 g was injected into uterine muscle. The bleeding， coagulation function and adverse reactions were compared between two groups. Result： The amount of postpartum hemorrhage at 2 and 24 h in the study group were lower than those in the control group （P<0.05）. There were no differences in APTT， TT， FIB and platelet count between two groups before operation （P>0.05）. After operation， APTT， TT， FIB and platelet count of two groups were lower than before operation， and the study group were lower than those of the control group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the study group was 10.00%， which was lower than 11.67% in the control group， but there was no significant difference between two groups （字2=0.678， P>0.05）. Conclusion： Compared with conventional Oxytocin treatment， Carboprost Tromethamine combined with Oxytocin in the prevention of postpartum hemorrhage after cesarean section has significant effect， can effectively improve maternal coagulation function. It reduce postpartum hemorrhage at 2， 12 h， and has high safety.

[Key words] Carboprost Tromethamine Oxytocin Cesarean section Postpartum hemorrhage Coagulation function

First-author’s address： Sanming Integrated Medicine Hospital， Sanming 365000， China

doi：10.3969/j.issn.1674-4985.2021.28.027

产后出血是产科常见并发症之一，尤其多见于剖宫产产妇[1]。剖宫产产妇由于手术切口较大，相对于顺产而言，出血量本身相对较大，当发生产后出血时，由于短期内出血量较多，产妇很容易在极短的时间内出现凝血功能障碍、出血性休克，甚至导致产妇死亡[2-3]。因此，如何使用药物有效预防产后出血一直是产科医师工作的重中之重。缩宫素是临床上预防产后出血的首选药物，卡前列素氨丁三醇也是近年来常用的预防产后出血的药物之一，而使用药物有效预防产后出血是产科工作的重中之重[4-5]。……