标题：卡孕栓联合缩宫素对瘢痕子宫剖宫产产后出血的预防效果

      作者：吴亚萍 1，瞿福娟 2，郭楚 1    1.南通市通州区二甲人民医院妇产科，江苏 南通 226321；2.南通市通州区人民医院妇产科，江苏 南通 226321

      卷次： 2019年30卷19期

      【摘要】 目的 研究卡孕栓联合缩宫素对瘢痕子宫剖宫产产后出血的预防效果，为患者的诊疗提供指导。方法 选择南通市通州区二甲人民医院妇产科 2016年 8月至 2018年 10月收治的 80例瘢痕子宫剖宫产的产妇进行研究。按照随机数表法将产妇均分为对照组和观察组各40例。对照组单纯实施缩宫素预防产后出血，观察组实施卡孕栓联合缩宫素预防产后出血。比较两组产妇产后2 h、24 h的出血量、肛门排气时间、宫高、凝血指标和不良反应情况。结果 观察组产妇产后2 h、24 h的出血量分别为(150.06±36.35) mL、(210.06±68.59) mL，均明显少于对照组的(190.05±49.63) mL、(250.08±58.46) mL，差异均有统计学意义(P<0.05)；观察组产妇的肛门排气时间为(12.05±5.54) h，明显短于对照组的(20.06±7.83) h，第1天、第2天宫高分别为(14.05±1.67) cm、(12.03±1.25) cm，均明显低于对照组的(16.07±1.45) cm、(14.06±1.77) cm，差异均有统计学意义(P<0.05)；观察组产妇的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平分别为(11.06±0.84) s、(26.43±3.51) s，明显低于对照组的(13.64±1.25) s、(34.46±4.02) s，D-二聚体(D-D)、纤维蛋白原(FIB)水平分别为(4.35±0.82) mg/L、(5.06±0.63) g/L，明显高于对照组的(2.84±0.93) mg/L、(3.37±0.74) g/L，差异均有统计学意义(P<0.05)；观察组和对照组产妇的不良反应发生率分别为12.50%、15.00%，差异无统计学意义(P>0.05)。结论 卡孕栓联合缩宫素对瘢痕子宫剖宫产产后出血的预防效果较好，能够改善产妇的凝血功能，减少出血量，值得在临床中应用。
      【关键词】 卡孕栓；缩宫素；瘢痕子宫；剖宫产；产后出血；效果
      【中图分类号】 R719.8 【文献标识码】 A 【文章编号】 1003—6350（2019）19—2518—03

Preventive effect of Carboprost Suppository combined with Oxytocin on postpartum hemorrhage after cesareansection of scarred uterus.
WU Ya-ping 1, QU Fu-juan 2, GUO Chu 1. 1.Department of Obstetrics and Gynecology,Second-class People's Hospital of Tongzhou District of Nantong City, Nantong 226321, Jiangsu, CHINA; 2. Department ofObstetrics and Gynecology, Tongzhou District People's Hospital, Nantong 226321, Jiangsu, CHINA
【Abstract】 Objective To study the preventive effect of Carboprost Suppository combined with Oxytocin onpostpartum hemorrhage after cesarean section of scarred uterus, and to provide guidance for the diagnosis and treatmentof patients. Methods Eighty patients of cesarean section with scar uterus in Second-class People's Hospital of Tong-zhou District of Nantong City from August 2016 to October 2018 were studied. According to the random number tablemethod, the parturients were divided into control group and observation group, with 40 parturients in each group. The con-trol group was only given Oxytocin to prevent postpartum hemorrhage, while the observation group was given CarboprostSuppository combined with Oxytocin to prevent postpartum hemorrhage. The bleeding volume, anal exhaust time, uterineheight, coagulation index, and adverse reactions of the two groups were compared and analyzed. Results The amount ofbleeding in the observation group at 2 h and 24 h after delivery was (150.06±36.35) mL and (210.06±68.59) mL, respec-tively, which were significantly lower than (190.05±49.63) mL and (250.08±58.46) mL in the control group (P<0.05). Thetime of anal exhaust in the observation group was (12.05±5.54) h, which was significantly shorter than (20.06±7.83) h inthe control group (P<0.05). The uterine height on the first day and the second day were (14.05±1.67) cm, (12.03±1.25) cm,which were significantly lower than (16.07±1.45) cm, (14.06±1.77) cm in the control group (P<0.05). The levels of pro-thrombin time (PT) and activated partial thromboplastin time (APTT) were (11.06±0.84) s and (26.43±3.51) s in the ob-servation group, which were significantly lower than (13.64±1.25) s, (34.46±4.02) s in the control group, and D-dimer,FIB levels were (4.35±0.82) mg/L and (5.06±0.63) g/L, respectively, significantly higher than (2.84±0.93) mg/L, (3.37±0.74) g/L in the control group (P<0.05). The incidence of adverse reactions in the observation group and the controlgroup were 12.50% and 15.00%, respectively, with statistically significant difference (P>0.05). Conclusion CarboprostSuppository combined with Oxytocin has better preventive effect on postpartum hemorrhage after cesarean section ofscarred uterus. It can improve the coagulation function of parturients and reduce the amount of bleeding, which is worthyof clinical application.
      【Key words】 Carboprost Suppository; Oxytocin; Scarred uterus; Cesarean section; Postpartum hemorrhage;Effect