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.
Abstract
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.
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