卡前列素氨丁三醇联合缩宫素治疗子宫收缩乏力性出血的临床研究

目的探讨卡前列素氨丁三醇注射液联合缩宫素注射液治疗子宫收缩乏力性出血的临床疗效。方法选取2015年1月—2017年5月西安市中心医院收治的子宫收缩乏力性出血产妇130例进行研究,所有产妇按随机数字表法分为对照组和治疗组,每组各65例。对照组在实施麻醉诱导前子宫肌壁注射缩宫素注射液10 U,然后改为静脉滴注,10 U加入到5%葡萄糖溶液500 m L中。治疗组在对照组基础上臀部肌内注射卡前列素氨丁三醇注射液,250 U/次,1.5~2 h重复注射1次,总注射剂量2 000 U。观察两组的临床疗效,比较两组的临床指标、凝血指标和卵巢功能。结果治疗后,对照组和治疗组的总有效率分别为80.00%、93.84%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组出血量、输血量均低于对照组,宫缩持续时间、住院时间、止血起效时间均短于对照组,两组比较差异有统计学意义(P0.05)。治疗3 d后,两组分泌凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)水平均显著升高,D-二聚体(D-D)水平均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后3个月,两组卵泡生成激素(FSH)、黄体生成激素(LH)水平均显著降低,雌二醇(E2)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论卡前列素氨丁三醇注射液联合缩宫素注射液治疗子宫收缩乏力性出血具有较好的临床疗效,可显著改善产妇的凝血功能,减少出血,调节激素水平,安全性良好,具有一定的临床推广应用价值。

Clinical study on carboprost tromethamine combined with oxytocin in treatment of uterine atony hemorrhage

Objective To investigate the clinical effect of Carboprost Tromethamine Injection combined with Oxytocin Injection in treatment of uterine atony hemorrhage. Methods Puerpera (130 cases) with uterine atony hemorrhage in Xi''an Central Hospital from February 2015 to May 2017were randomly divided into control and treatment groups, and each group had 65 cases. Puerpera in the control group were injection administered with Oxytocin Injection 10 U into the uterine wall before the induction of anesthesia, then instead of intravenous drip, 10 U added into 5% glucose solution 500 mL. Puerpera in the treatment group were intramuscular injection administered with Carboprost Tromethamine Injection ati the hips on the basis of the control group, 250 U/time, after 1.5 to 2 h, repeated injections 1 time. Total injection dose is less than 2 000 U. After treatment, the clinical efficacies were evaluated, and clinical indicators, blood coagulation indexes, and ovarian function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 93.84%, respectively, and there was difference between two groups (P<0.05). After treatment for 3 d, the amounts of bleeding and blood transfusion in the treatment group were lower than those in the control group, but contraction duration, hospitalization time, and onset time of hemostasis in the treatment group were shorter than those in the control group, and there was difference between two groups (P<0.05). Three months after treatment, the levels of APTT, PT, and FIB in two groups were significantly increased, but the levels of D-D in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of FSH and LH in two groups were significantly decreased, but the level of E₂ in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Carboprost tromethamine combined with oxytocin has clinical curative effect in treatment of uterine atony hemorrhage, can significantly improve the coagulation function, decrease the amount of bleeding, and regulate hormone level, with good safety, which has a certain clinical application value.