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临床研究
| 作者: |
1谷琳,
1杨帆,
1刘庆研,
1郑蓉
1 北京积水潭医院妇产科，北京 100036 |
| 通讯: |
谷琳
Email: bjgl741@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.09.015 |
摘要
目的：观察缩宫素+米索+卡前列素氨丁三醇治疗胎盘早剥产后大出血的疗效。方法：选取2017年5月至2020年5月北京积水潭医院收治的82例胎盘早剥产后大出血患者为对象，采用随机数字表法将其均分为观察组(n=41)和对照组(n=41)，对照组给予缩宫素、米索治疗，观察组给予缩宫素、米索和卡前列素氨丁三醇治疗，比较两组治疗后的临床疗效、术中和术后出血量、持续出血时间、住院时间、血压、心率及不良反应发生率。结果：治疗后观察组术中出血量(453.27±20.21) mL，术后10 min出血量(227.47±12.25) mL，术后60 min出血量(257.17±12.61) mL，术后2 h出血量(297.31±15.12) mL，术后24 h出血量(318.56±15.84) mL，持续出血时间(28.12±6.51) h，均显著低于对照组的(553.37±25.33) mL、(310.51±15.24) mL、(368.09±16.07) mL、(411.23±18.19) mL、(436.16±18.77) mL及(36.57±4.43) h (均P<0.05)；治疗后观察组血红蛋白含量(124.33±15.20) g/L高于对照组的(108.41±13.60) g/L，止血时间(18.35±5.12) min和住院时间(6.28±1.31) d均短于对照组的(30.28±10.46) min和(9.29±2.62) d (均P<0.05)；治疗后观察组有效率高于对照组(87.80% vs 63.41%)(P<0.05)；治疗后两组舒张压、收缩压、心率及不良反应发生率均无显著性差异(均P>0.05)。结论：联合使用缩宫素、米索和卡前列素氨丁三醇治疗胎盘早剥产后大出血的临床疗效显著，可缩短持续性出血时间和住院时间，值得临床进一步推广。
关键词：
胎盘早剥产后大出血；缩宫素；米索；卡前列素氨丁三醇
Clinical study on the treatment of massive hemorrhage after placental abruption with oxytocin, misoprostol and carboprost tromethamine
CorrespondingAuthor: GU Lin Email: bjgl741@163.com
DOI: 10.3978/j.issn.2095-6959.2021.09.015
Abstract
Objective: To observe the therapeutic effect of oxytocin, misoprostol and carboprost tromethamine on massive hemorrhage after placental abruption. Methods: From May 2017 to May 2020, 82 patients with postpartum hemorrhage after placental abruption were selected from Beijing Jishuitan Hospital. By using random number table method, they were divided into an observation group (n=41) and a control group (n=41). The control group was treated with oxytocin and misoprostol, while the observation group was given oxytocin, misoprostol and carboprost tromethamine to treat. The clinical efficacy after treatment, intraoperative and postoperative blood loss, continuous bleeding time, the length of hospital stay, blood pressure, heart rate and adverse reaction rate were compared between the 2 groups. Results: After the treatment, the intraoperative blood loss, blood loss at 10 min, 60 min, 2 h and 24 h after operation, and bleeding duration of the observation group were (453.27±20.21) mL, (227.47±12.25) mL, (257.17±12.61) mL, (297.31±15.12) mL, (318.56±15.84) mL, and (28.12±6.51) h, respectively, significantly less or shorter than those [(553.37±25.33) mL, (310.51±15.24) mL, (368.09±16.07) mL, (411.23±18.19) mL, (436.16±18.77) mL and (36.57±4.43) h, respectively] of the control group (P<0.05). Additionally, the hemoglobin level in the observation group was (124.33±15.20) g/L, higher than that [(108.41±13.60) g/L] in the control group. The hemostasis time and length of hospital stay were (18.35±5.12) min and (6.28±1.31) d, shorter than those [(30.28±10.46) min and (9.29±2.62) d] of the control group (P<0.05). After the treatment, the effective rate in the observation group was 87.80%, higher than 63.41% in the control group (P<0.05). Meanwhile, there were no significant differences in diastolic blood pressure, systolic blood pressure, heart rate, and the incidence of adverse reactions between the 2 groups after the treatment (P>0.05). Conclusion: The combined use of oxytocin, misoprostol and carboprost tromethamine can achieve significant clinical effects in the treatment of massive hemorrhage after placental abruption. It can shorten the duration of bleeding and the length of hospital stay, and is worthy of further promotion in clinical practice.
Keywords：
massive hemorrhage after placental abruption; oxytocin; misoprostol; carboprost tromethamine