摘要
目的探究卡前列素氨丁三醇联合麦角新碱治疗产后出血高危产妇的疗效。方法回顾性纳入宁德师范学院附属宁德市医院2022年5月至2025年5月予以针对性治疗的产后出血高危产妇100例为研究对象,按用药方案差异分为卡前列素组和麦角新碱组。卡前列素组50例产妇予以卡前列素氨丁三醇治疗,麦角新碱组50例产妇加用麦角新碱治疗。对比卡前列素组和麦角新碱组临床疗效、出血情况(产后2 h、24 h总出血量)、产后恢复情况(宫缩持续时长、红色及浆液性恶露持续时长、止血时长)、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)]、血常规指标[血红蛋白(Hb)、血小板计数(PLT)]以及不良反应。结果麦角新碱组总有效率为94.00%(47/50),高于卡前列素组的74.00%(37/50)(χ^(2)=7.440,P<0.05)。麦角新碱组产后2、24 h总出血量[分别为(436.20±70.61)mL、(489.90±64.78)mL]均少于卡前列素组[分别为(478.60±73.22)mL、(549.06±65.82)mL](t=2.947、4.529,均P<0.05)。麦角新碱组宫缩持续时长[(3.78±1.86)h]长于卡前列素组[(1.85±0.91)h](t=6.591,P<0.05),红色及浆液性恶露持续时长、止血时长[分别为(14.24±2.08)d、(10.18±1.82)h]均短于卡前列素组[(20.56±2.25)d、(17.24±1.29)h](t=14.690、22.381,均P<0.05)。治疗后,卡前列素组和麦角新碱组PT、APTT、FIB水平较治疗前降低,且麦角新碱组PT、APTT、FIB水平[(9.68±0.53)s、(29.99±1.36)s、(2.96±0.30)g/L]低于卡前列素组[(10.53±0.66)s、(32.85±1.76)s、(3.31±0.27)g/L](t=7.101、9.092、6.132,均P<0.05);卡前列素组和麦角新碱组Hb、PLT水平较治疗前降低,且麦角新碱组Hb、PLT水平[分别为(115.06±15.63)g/L、(191.04±24.70)×10^(9)/L]高于卡前列素组[分别为(108.14±12.29)g/L、(180.80±25.97)×10^(9)/L](t=2.461、2.176,均P<0.05)。在不良反应发生率方面,麦角新碱组为10.00%(5/50),卡前列素组为18.00%(9/50),差异无统计学意义(χ^(2)=1.329,P>0.05)。结论卡前列素氨丁三醇联合麦角新碱治疗对产后出血高危产妇具有良好的疗效,能有效改善产妇产后恢复状态、促进凝血功能恢复、控制出血量和缩短止血时长,且安全性较好。
Objective To investigate the efficacy of carboprost tromethamine combined with ergometrine in the treatment of high-risk parturients for postpartum hemorrhage(PPH).Methods A total of 100 parturients with high-risk factors for PPH treated at Ningde Municipal Hospital of Ningde Normal University from May 2022 to May 2025 was retrospectively selected and divided into the carboprost group and the ergometrine group based on the medication regimen,with 50 cases in each group.The carboprost group was treated with carboprost tromethamine,while the ergometrine group was treated with carboprost tromethamine combined with ergometrine.The clinical efficacy,bleeding conditions(total bleeding loss at 2 hours and 24 hours postpartum),postpartum recovery(duration of uterine contractions,duration of red and serous lochia,and hemostasis time),coagulation function indicators(activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB)),blood routine indicators(hemoglobin(Hb),platelet count(PLT)),and adverse reactions between the two groups were compared.Results The total effective rate in the ergometrine group was 94.00%(47/50),higher than that in the carboprost group(74.00%,37/50)(χ^(2)=7.440,P<0.05).The total blood loss at 2 h and 24 h postpartum in the ergometrine group((436.20±70.61)mL,(489.90±64.78)mL,respectively)were less than those in the carboprost group((478.60±73.22)mL,(549.06±65.82)mL,respectively)(t=2.947,4.529,both P<0.05).The duration of uterine contraction in the ergometrine group((3.78±1.86)h)was longer than that in the carboprost group((1.85±0.91)h)(t=6.591,P<0.05).The duration of red and serous lochia and hemostasis time in the ergometrine group((14.24±2.08)d,(10.18±1.82)h,respectively)were shorter than those in the carboprost group((20.56±2.25)d,(17.24±1.29)h,respectively)(t=14.690,22.381,both P<0.05).The levels of PT,APTT,and FIB in both groups decreased compared to pre-treatment levels,and the above indicators in the ergometrine group((9.68±0.53)s,(29.99±1.36)s,(2.96±0.30)g/L)were lower than those in the carboprost group((10.53±0.66)s,(32.85±1.76)s,(3.31±0.27)g/L)(t=7.101,9.092,6.132,all P<0.05).Both groups showed decreased levels of Hb and PLT compared to pre-treatment values,and the levels of Hb and PLT in the ergometrine group((115.06±15.63)g/L,(191.04±24.70)×10^(9)/L)were higher than those in the carboprost group((108.14±12.29)g/L,(180.80±25.97)×10^(9)/L)(t=2.461,2.176,both P<0.05).The incidence of adverse reactions was 10.00%(5/50)in the ergometrine group and 18.00%(9/50)in the carboprost group,with no statistically obvious difference between the two groups(χ^(2)=1.329,P>0.05).Conclusion The combination of carboprost tromethamine and ergometrine demonstrates good efficacy in treating high-risk parturients for PPH.It can effectively improve postpartum recovery,promote the recovery of coagulation function,control blood loss,shorten hemostasis time,with a favorable safety profile.
作者
倪银芳
陈洵艳
刘小静
NI Yinfang;CHEN Xunyan;LIU Xiaojing(Department of Obstetrics,Ningde Municipal Hospital of Ningde Normal University,Ningde 352100,China)
出处
《中国药物应用与监测》
2025年第9期1560-1564,共5页
Chinese Journal of Drug Application and Monitoring
关键词
卡前列素氨丁三醇
麦角新碱
产后出血
高危因素
疗效
carboprost tromethamine
ergometrine
postpartum hemorrhage
high-risk factor
efficacy
