卡贝缩宫素联合Bakri球囊压迫对宫缩乏力性产后出血患者卵巢功能和凝血功能的影响

目的:探讨卡贝缩宫素、Bakri球囊压迫联合治疗对宫缩乏力性产后出血患者卵巢功能以及凝血功能的影响。方法:选取2017年2月-2021年3月我院接诊治疗的86例宫缩乏力性产后出血患者,以随机数字表法分为对照组、研究组,分别给予Bakri球囊压迫单一治疗及卡贝缩宫素、Bakri球囊压迫联合治疗。检测对比患者的卵巢功能指标包括LH、FSH、E2水平,记录两组患者舒张压(DBP)、收缩压(SBP)、心率、出血量变化和止血起效时间,测定纤维蛋白原(FIB)、凝血酶原时间(PT)和活化部分凝血活酶时间(APTT),对比两组不良反应发生情况。结果:两组患者DBP、SBP及心率变化波动较小,治疗后数据显示差异无统计学意义(P>0.05);两组患者治疗后2 h、24 h出血量减少,且研究组治疗后2 h、24 h出血量及止血起效时间短于对照组(P<0.05);治疗后3 d,两组患者FIB水平降低,PT、APPT水平升高,且研究组FIB水平低于对照组,PT、APPT水平高于对照组(P<0.05);治疗后3 d,两组患者血清E₂水平升高,FSH、LH水平降低,且研究组血清E₂、FSH、LH水平优于对照组(P<0.05);研究组不良反应发生率(8.89%)高于对照组(4.88%),但是未见显著性差异(P>0.05)。结论:卡贝缩宫素联合Bakri球囊压迫可改善宫缩乏力性产后出血的卵巢功能及凝血功能,提升产后止血效果,增强患者子宫收缩能力。

Effects of Carbetocin Combined with Bakri Balloon Compression on Ovarian Function and Coagulation Function in Patients with Uterine Asthenia Postpartum Hemorrhage

Objective:To investigate the effects of carbetocin and Bakri balloon compression on ovarian function and coagulation function in patients with uterine asthenia postpartum hemorrhage.Methods:86 patients with uterine asthenia postpartum hemorrhage who were treated in our hospital from February 2017 to March 2021 were selected,and they were randomly divided into control group and study group by random number table method.They were treated with Bakri balloon compression alone and carbetocin and Bakri balloon compression combined.Ovarian function indexes including luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E₂)were detected and compared.The changes of diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate,bleeding volume and hemostasis onset time in two groups were recorded.Fibrinogen(FIB),prothrombin time(PT)and activated partial thromboplastin time(APTT)were measured,the adverse reactions of the two groups were compared.Results:The changes of DBP,SBP and heart rate in the two groups fluctuated little,and there was no significant difference after treatment(P>0.05).The bleeding volume at 2 h and 24 h after treatment in two groups decreased,and the bleeding volume and hemostasis onset time in the study group at 2 h and 24 h after treatment were shorter than those in the control group(P<0.05).3 d after treatment,the level of FIB in the two groups decreased,and the levels of PT and APTT increased,and the level of FIB in the study group was lower than that in the control group,and the levels of PT and APPT were higher than those in the control group(P<0.05).3 d after treatment,the levels of serum E₂ in the two groups increased,and the levels of FSH and LH decreased,and the levels of serum E₂,FSH and LH in the study group were better than those in the control group(P<0.05).The incidence of adverse reactions in the study group(8.89%)was higher than that in the control group(4.88%),but there was no significant difference(P>0.05).Conclusion:The combined treatment of carbetocin and Bakri balloon compression can effectively improve the ovarian function and coagulation function of patients with uterine asthenia postpartum hemorrhage,improve the postpartum hemostasis effect,and enhance the uterine contractility of patients.