摘要
目的:探讨麦角新碱与卡前列素氨丁三醇联合预防瘢痕子宫再次剖宫产患者产后出血的效果及对谷胱甘肽过氧化物酶(GSH-px)、超氧化物歧化酶(SOD)、丙二醛(MDA)、产后泌乳情况的影响。方法:选取2018年2月至2020年4月我院瘢痕子宫再次剖宫产患者92例为研究对象,以简单随机化法分为观察组与对照组,各46例。对照组应用卡前列素氨丁三醇预防产后出血,观察组应用麦角新碱联合卡前列素氨丁三醇预防产后出血。对比两组疗效、产后出血情况、恢复情况、泌乳情况、不良反应与术前、术后24h的凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D)]、血清GSH-px、SOD、MDA水平。结果:经治疗,观察组总有效率93.48%高于对照组76.09%(P<0.05);观察组产后2h、24h出血量、产后出血率较对照组低,恶露持续时间、住院时间较对照组短,子宫底下降速度较对照组快(P<0.05);两组术后24h APTT、PT、FIB、D-D与血清MDA水平较术前降低,且观察组低于对照组,血清GSH-px、SOD水平较术前提高,且观察组高于对照组(P<0.05);观察组泌乳启动时间较对照组短,产后1d、2d泌乳量评分较对照组高(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论:应用麦角新碱与卡前列素氨丁三醇联合预防瘢痕子宫再次剖宫产患者产后出血可显著提升预防效果,减少产后出血,促进患者恢复,改善凝血功能、泌乳情况,降低血清GSH-px、SOD、MDA水平,减轻氧化应激反应,且安全性良好。
Objective:To investigate the effect of the combination of Ergometrine and Carboprost Tromethamine Injection in preventing postpartum hemorrhage in patients with scarred uterus re-cesarean section and its influence on glutathione peroxidase(GSH-px),superoxide dismutase(SOD),malondialdehyde(MDA)and postpartum lactation.Methods:A total of 92 patients with scarred uterus re-cesarean section in our hospital from February 2018 to April 2020 were selected as the research objects.They were divided into observation group and control group by simple randomization method,with 46 cases in each group.The control group was treated with Carboprost Tromethamine Injection to prevent postpartum hemorrhage,and the observation group was treated with Ergometrine combined with Carboprost Tromethamine Injection to prevent postpartum hemorrhage.The efficacy,postpartum hemorrhage,recovery,lactation,and adverse reactions,coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),D-dimer(DD)],serum GSH-px,SOD,MDA levels before and 24 hours after the operation of the two groups were compared.Results:After treatment,the total effective rate of the observation group was 93.48%higher than that of the control group 76.09%(P<0.05).The bleeding volume and rate of postpartum hemorrhage at 2 h and 24 h in the observation group were lower than those in the control group,the duration of lochia and hospital stay were shorter than those in the control group,and the uterine fundus declined faster than the control group(P<0.05).The levels of APTT,PT,FIB,DD,and serum MDA in the two groups at 24 h after surgery were lower than those before the operation,and the observation group was lower than the control group,and the serum GSH-px and SOD levels were higher than those before operation,and the observation group was higher than the control group(P<0.05).The lactation initiation time of the observation group was shorter than that of the control group,and the lactation volume scores of the 1 and 2 d postpartum were higher than those of the control group(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined application of Ergometrine and Carboprost Tromethamine Injection to prevent postpartum hemorrhage in patients with scarred uterus re-cesarean section can significantly improve the preventive effect,reduce postpartum hemorrhage,and promote the recovery of patients,improve coagulation function and lactation,reduce serum GSH-px,SOD,MDA levels,reduce oxidative stress,and have good safety.
作者
仇茜
姚荣华
黄俊杰
俞敏
QIU Qian;YAO Ronghua;HUANG Junjie(Joint Logistics Support Force 901 Hospital, Anhui Hefei 230031, China)
出处
《河北医学》
CAS
2021年第11期1901-1907,共7页
Hebei Medicine
基金
2020年度安徽省自然科学基金项目,(编号:2008085MF214)。
关键词
麦角新碱
卡前列素氨丁三醇
瘢痕子宫再次剖宫产
产后出血
泌乳情况
氧化应激
Ergometrine
Carboprost tromethamine injection
Re-cesarean section with scarred uterus
Postpartum hemorrhage
Lactation status
Oxidative stress
