卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者NONOSFIBDdimer泌乳功影响
[摘]目：研究卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者氧化氮（NO）氧化氮合酶（NOS）纤维蛋白原( FIB)D二聚体( Ddimer)泌乳功影响方法：选取院2015年6月2017年6月具剖宫产手术指证孕产妇119例分观察组组组予注射卡前列素氨丁三醇治疗观察组予注射卡前列素氨丁三醇联合卡贝缩宫素治疗观察两组治疗床疗效检测治疗前NONOSFIBDdimer水泌乳功结果：治疗观察组子宫复旧效率932明显高组子宫复旧效率746差异显著（P<005）观察组NONOSFIBDdimer水均显著低组较具统计学意义（P<005）观察组术2h出血量术24h出血量产出血率宫缩持续时间恶露持续时间均低组较具统计学意义（P<005）观察组泌乳时间低观察组产1d泌乳量评分产2d泌乳量评分均高组较具统计学意义（P<005）结卡前列素氨丁三醇联合卡贝缩宫素治疗剖宫产产出血患者效降低患者NONOSFIBDdimer水2h出血量术24h出血量产出血率宫缩持续时间恶露持续时间改善患者泌乳时间提高患者1d泌乳量评分产2d泌乳量评分
关键词卡前列素氨丁三醇卡贝缩宫素NOFIBDdimerNOS剖宫产产出血
中图分类号：R71462 文献标识码：A 文章编号：
Effects of caffeine tromethamine combined with carbene oxytocin on NO NOS FIB Ddimer and lactation in patients with postpartum hemorrhage
[Abstract] Objective To study effects of caffeine tromethamine combined with carbene oxytocin on NO NOS FIB Ddimer and lactation in patients with postpartum hemorrhage Methods 118 patients of cesarean section bleeding whoreceived therapy from June 2015 to June 2017in our hospital wereselected as research objects According to different treatment optionsthose patients were divided into the control group ( n 59) and the observation group ( n 59)the control group was treated withCard prostaglandin tromethamine drug therapy while the observation group was treated with Prostaglandin tromethamine combined with carbene oxytocin the clinical efficacy of the two groups was observed and the levels of NO NOS FIB Ddimer and lactation were measured before and after treatment Results After treatment the effective rate of uterine recovery was 932 in the observation group which was significantly higher than that in the control group (746) The difference was significant (P <005)the levels of NO NOS FIB and Ddimer in the observation group were significantly lower than those in the control group (P <005) the time of lactation in the observation group was lower than that in the control group (P <005) and the time of postoperative hemorrhage postpartum hemorrhage rate duration of uterine contusion and duration of lochia were lower than those of the control group (P <005) The scores of lactation and postpartum 2d lactation were significantly higher in the observation group than in the control group (P <005)Conclusion the levels of NO NOS FIB Ddimer and 2h bleeding in patients with postpartum hemorrhage were significantly lower than those in patients with postpartum hemorrhage Duration and duration of lochia improve the time of lactation improve the 1d lactation score and postpartum 2d lactation score
key words Pentoprostin Cobia oxytocin NO FIB Ddimer NOS cesarean section postpartum hemorrhage
Chinese Library Classification(CLC) R71462 Document code A
Article ID
产出血产妇死亡重素[1]引起产妇出血原：（1）产妇紧张精神状况引起子宫收缩力变差导致产出血（2）胎盘滞留包括胎盘剥落全胎盘粘连等（3）凝血功障碍产妇血液病肝炎等高度高危素[2]须做产前检查血液病肝炎次刮宫史产妇提前入院观察备血预防分娩时出现意外[3]剖宫产出血正常阴道分娩较剖宫产产妇产出血发生率较高产出血病中部分子宫收缩乏力引起预防子宫乏力性出血具重床意义[45]卡前列素氨丁三醇够提高钙离子浓度刺激促进子宫滑肌收缩预防产出血治疗定疗效[6]卡贝缩宫素属种催产素专门预防治疗宫缩乏力引起产出血传统缩宫素制剂较具起效快效果持久便捷等特点[78]卡前列素氨丁三醇联合卡贝缩宫素治疗剖宫产产出血患者具良床疗效效提高患者康复率降低产妇FIBDDimer检测值NONOS水产出血量降低提高产妇泌乳量评分文旨研究卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者NONOSFIBDdimer泌乳功影响现结果报道
1材料方法
11般资料
选取院2015年6月2017年6月具剖宫产手术指证孕产妇119例纳入标准[9]：（1）家属知情签署意书（2）产妇均符合剖宫产诊断指标排标准：（1）患高血压心脏病者（2）患重肝炎者血液疾病者入选患者根治疗方案分观察组（n59）年龄22~36岁均年龄（3149±449）岁孕周37~44周均（3942±553）周剖宫产手术指证：巨33例羊水11例胎妊娠双胎15例组（n59）年龄21~38岁均年龄（2919±339）岁孕周35~41周均（3752±493）周剖宫产手术指证：巨27例羊水19例胎妊娠双胎13例两组产妇年龄孕周等方面较统计学意义（P>005）具性
12方法
产妇均采子宫段横切口剖宫产术胎娩出组予卡前列素氨丁三醇注射液（生产厂家：Pharmacia & Upjohn company 1ml：250μg进口药物注册证号：H20120388）250 μg 宫体注射术2h注射次观察组组治疗基础联合卡贝缩宫素（辉凌制药限公司 支100μg：1ml 20150101）100μg：(1ml)静脉注射连续两天
13观察指标
记录产妇术224h出血量产出血发生率子宫收缩持续时间恶露持续时间FIB采免疫浊法Ddimer采ELISA法检测产出血量计算方法：出血量［胎娩出接血敷料湿重( g)－接血前敷料干重( g) 1 05( 血液重 gmL) 泌乳时间胎盘娩出乳房第次溢乳时间泌乳量评分：挤奶乳汁表现喷射状吸允乳房然没排空3分手法挤奶存奶乳汁溢出情况哺乳时间超8次d新生便超1次d便超5次d哺乳婴较安全乳房松软2分满足婴需添加代乳品1分没乳汁分泌0分
疗效标准参相关文献进行[10]：（1）子宫复旧良：产妇子宫收缩（2）子宫复旧良：产妇子宫收缩差
14统计学分析
研究数选择spss180进行统计较计量资料采t检验计数资料采χ2检验等级资料较秩检验P<005时表示差异显著
2结果
21两组产妇子宫复旧疗效较治疗观察组子宫复旧效率932明显高组子宫复旧效率746差异显著（P<005）见表1
表1 两组产妇子宫复旧疗效较[n()]
Table 1 Comparison of efficacy of two groups[n()]
Group
n
The uterus is well restored
Improved uterine healing
Uterine bad old
Efficient
Observation group
59
35（593）
20（339）
4（68）
932 a
Control group
59
29（492）
15（254）
15（254）
746
Note Compared with the control group a P＜005
22两组患者治疗前FIBDDimer检测值较：治疗前两组FIBDDimer检测值均较意义（P>005）治疗观察组FIBDDimer检测值均低组FIBDDimer检测值差异具较意义（P<005）见表2
表2 两组患者治疗前FIBDDimer检测值较（±s）
Table 2 Comparison of FIB DDimer between the two groups before and after treatment（±s）
Group
n
Time
FIB（gL）
DDimer（mgL）
Observation group
59
Before treatment
469±058
355±038
After treatment
347±045ab
122±025ab
Control group
59
Before treatment
466±050
354±037
After treatment
462±049b
346±035b
Note Compared with the control group aP＜005 Compared with Before treatment bP ＜005
23两组患者治疗前NONOS水较：治疗前两组NONOS水均较意义（P>005）治疗观察组NONOS水均低组NONOS水差异具较意义（P<005）见表3
表3 两组患者治疗前NONOS水较（±s）
Table 3 Comparison of NONOS levels between the two groups before and after treatment（±s）
Group
n
Time
NO（ μ m mo l L）
NOS（UmL）
Observation group
59
Before treatment
10524±1137
3832±471
After treatment
4132±527ab
1828±258ab
Control group
59
Before treatment
10333±1121
3767±477
After treatment
8819±938b
3156±401b
Note Compared with the control group aP＜005 Compared with Before treatment bP <005
24两组患者术出血情况较：观察组术2h出血量（23532±3519）术24h出血量（30134±3411）产出血率（51）宫缩持续时间（155±023）恶露持续时间（1533±287）均低组术2h出血量（36783±4089）术24h出血量（45319±4935）产出血率（186）宫缩持续时间（327±042）恶露持续时间（2119±312）差异具统计学意义（P<005）见表4
表4 两组患者术出血情况较（±s）
Table 4 Comparison of postoperative bleeding in both groups（±s）
Group
n
2 hours after surgery bleeding（ml）
24 hours after surgery bleeding（ml）
Postpartum hemorrhage rate n（）
Contractions lasted（h）
The duration of the lochia（d）
Observation group
59
23532±3519a
30134±3411a
3（51）a
155±023a
1533±287a
Control group
59
36783±4089
45319±4935
11（186）
327±042
2119±312
Note Compared with the control group aP＜005
25两组患者产泌乳时间泌乳量评分较：观察组泌乳时间（2038±318）低组泌乳时间（2708±353）观察组产1d泌乳量评分（157±026）产2d泌乳量评分（197±031）均高组产1d泌乳量评分（121±019）产2d泌乳量评分（153±025）差异具统计学意义（P<005）见表5
表5 两组患者产泌乳时间泌乳量评分较（±s）
Table 5 Comparison of postpartum lactation time and lactation score between the two groups（±s）
Group
n
Lactation time（h）
Postpartum 1d lactation score（Minute）
Postpartum 2d lactation score（Minute）
Observation group
59
2038±318a
157±026a
197±031a
Control group
59
2708±353
121±019
153±025
Note Compared with the control group aP＜005
3讨
产出血妇产科常见发症发病原较包括宫缩乏力凝血功障碍胎盘组织功异常等中宫缩乏力常见发病原[1112]引起宫缩乏力原产妇精神紧张体质虚弱子宫肌壁损伤患慢性疾病等剖宫产正常阴道分娩较剖宫产产妇般存巨胎妊娠前置胎盘等高危素加麻醉手术等影响产出血率显著提高剖宫产产妇新生造成严重威胁[13]预测剖宫产产出血史剖宫产手术程中重环节[14]
Ddimer交联纤维蛋白种降解产物反映纤维蛋白溶解功[15]机体血活化血栓形成纤维溶解活动Ddimer会升高[16]产出血具定预测作通Ddimer检测值变化判断剖宫产产出血危险素[17]FIB肝脏合成糖蛋白水升高时容易形成血栓[18]种种αAβBv链组成二聚体存吸附血浆中[19]具促进血板聚集滑肌生长皮细胞收缩增加血液粘滞性等作容易引起细胞损伤预防治疗剖宫产出血患者具重床意义通检测产妇FIB变化诊断出患者出血发生率[20]
NO种细胞毒性效应器种生物体许部分信号分子具较复杂生物学效应促进毛细血渗出[2122]NO具抑制宫缩作子宫滑肌活动密切相关NOS机体氧化合成限速酶活性NO水相关产妇子宫肌层胎盘组织等存NOS活性产妇妊娠中期检测NOS稳定表达宫缩乏力性产出血发生息息相关[23]通检测NONOS水变化观察产妇胎盘血流量子宫滑肌松弛度变化
泌乳种激素作已发育乳腺引起产妇通调节分泌系统促进乳腺中导系统生长发育生乳源泌乳通畅产妇感疼痛丘脑刺激催乳素抑制子降低泌乳素分泌抑制泌乳反射延迟泌乳减少泌乳量降低乳汁中蛋白质含量新生吸吮乳头刺激挤奶时工摩乳房刺激影响泌乳活动组织乳腺发育切断乳腺神[24]
卡前列素氨丁三醇称欣母沛前列腺2a种衍生物通提高肌细胞钙离子浓度形成诱发滑肌收缩机制达刺激子宫肌层协调力收缩作[25]效预防产妇产出血状况生物活性明显高传统前列腺素类药物剖宫产产妇该药促进子宫肌肉收缩胎盘处发挥止血效果旦注入宫体快速通血液循环发挥药效刻钟达高药物浓度[26]
卡贝缩宫素床防治产出血情况具[2728]：（1）起效快持续时间短需反复次药（2）子宫段收缩刺激作（3）子宫滑肌敏感性孕激素雄激素水密切相关等特点严重产出血卡贝缩宫素药效明显需加子宫收缩剂价钱传统缩宫素贵属常规药[2930]
研究显示单卡前列素氨丁三醇治疗剖宫产出血患者效率较低患者FIBDDimer检测值NONOS水变化明显[30]卡前列素氨丁三醇联合卡贝缩宫素产妇子宫复旧效率932明高单卡前列素氨丁三醇产妇子宫复旧效率746效果显著具较意义卡前列素氨丁三醇联合卡贝缩宫患者中FIBDDimer检测值NONOS水均低单卡前列素氨丁三醇患者联合药者术2h出血量术24h出血量产出血率均低单药者宫缩持续时间恶露持续时间均明显高单药者联合药者泌乳时间低单药者产1d泌乳量评分产2d泌乳量评分均显著升高见卡前列素氨丁三醇联合卡贝缩宫素治疗剖宫产出血患者效果显著具床意义
综述卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者种预防方案够显著减少剖宫产产出血降低产出血发生率促进产恢复值床推广应
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[摘]目：研究卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者氧化氮（NO）氧化氮合酶（NOS）纤维蛋白原( FIB)D二聚体( Ddimer)泌乳功影响方法：选取院2015年6月2017年6月具剖宫产手术指证孕产妇119例分观察组组组予注射卡前列素氨丁三醇治疗观察组予注射卡前列素氨丁三醇联合卡贝缩宫素治疗观察两组治疗床疗效检测治疗前NONOSFIBDdimer水泌乳功结果：治疗观察组子宫复旧效率932明显高组子宫复旧效率746差异显著（P<005）观察组NONOSFIBDdimer水均显著低组较具统计学意义（P<005）观察组术2h出血量术24h出血量产出血率宫缩持续时间恶露持续时间均低组较具统计学意义（P<005）观察组泌乳时间低观察组产1d泌乳量评分产2d泌乳量评分均高组较具统计学意义（P<005）结卡前列素氨丁三醇联合卡贝缩宫素治疗剖宫产产出血患者效降低患者NONOSFIBDdimer水2h出血量术24h出血量产出血率宫缩持续时间恶露持续时间改善患者泌乳时间提高患者1d泌乳量评分产2d泌乳量评分
关键词卡前列素氨丁三醇卡贝缩宫素NOFIBDdimerNOS剖宫产产出血
中图分类号：R71462 文献标识码：A 文章编号：
Effects of caffeine tromethamine combined with carbene oxytocin on NO NOS FIB Ddimer and lactation in patients with postpartum hemorrhage
[Abstract] Objective To study effects of caffeine tromethamine combined with carbene oxytocin on NO NOS FIB Ddimer and lactation in patients with postpartum hemorrhage Methods 118 patients of cesarean section bleeding whoreceived therapy from June 2015 to June 2017in our hospital wereselected as research objects According to different treatment optionsthose patients were divided into the control group ( n 59) and the observation group ( n 59)the control group was treated withCard prostaglandin tromethamine drug therapy while the observation group was treated with Prostaglandin tromethamine combined with carbene oxytocin the clinical efficacy of the two groups was observed and the levels of NO NOS FIB Ddimer and lactation were measured before and after treatment Results After treatment the effective rate of uterine recovery was 932 in the observation group which was significantly higher than that in the control group (746) The difference was significant (P <005)the levels of NO NOS FIB and Ddimer in the observation group were significantly lower than those in the control group (P <005) the time of lactation in the observation group was lower than that in the control group (P <005) and the time of postoperative hemorrhage postpartum hemorrhage rate duration of uterine contusion and duration of lochia were lower than those of the control group (P <005) The scores of lactation and postpartum 2d lactation were significantly higher in the observation group than in the control group (P <005)Conclusion the levels of NO NOS FIB Ddimer and 2h bleeding in patients with postpartum hemorrhage were significantly lower than those in patients with postpartum hemorrhage Duration and duration of lochia improve the time of lactation improve the 1d lactation score and postpartum 2d lactation score
key words Pentoprostin Cobia oxytocin NO FIB Ddimer NOS cesarean section postpartum hemorrhage
Chinese Library Classification(CLC) R71462 Document code A
Article ID
产出血产妇死亡重素[1]引起产妇出血原：（1）产妇紧张精神状况引起子宫收缩力变差导致产出血（2）胎盘滞留包括胎盘剥落全胎盘粘连等（3）凝血功障碍产妇血液病肝炎等高度高危素[2]须做产前检查血液病肝炎次刮宫史产妇提前入院观察备血预防分娩时出现意外[3]剖宫产出血正常阴道分娩较剖宫产产妇产出血发生率较高产出血病中部分子宫收缩乏力引起预防子宫乏力性出血具重床意义[45]卡前列素氨丁三醇够提高钙离子浓度刺激促进子宫滑肌收缩预防产出血治疗定疗效[6]卡贝缩宫素属种催产素专门预防治疗宫缩乏力引起产出血传统缩宫素制剂较具起效快效果持久便捷等特点[78]卡前列素氨丁三醇联合卡贝缩宫素治疗剖宫产产出血患者具良床疗效效提高患者康复率降低产妇FIBDDimer检测值NONOS水产出血量降低提高产妇泌乳量评分文旨研究卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者NONOSFIBDdimer泌乳功影响现结果报道
1材料方法
11般资料
选取院2015年6月2017年6月具剖宫产手术指证孕产妇119例纳入标准[9]：（1）家属知情签署意书（2）产妇均符合剖宫产诊断指标排标准：（1）患高血压心脏病者（2）患重肝炎者血液疾病者入选患者根治疗方案分观察组（n59）年龄22~36岁均年龄（3149±449）岁孕周37~44周均（3942±553）周剖宫产手术指证：巨33例羊水11例胎妊娠双胎15例组（n59）年龄21~38岁均年龄（2919±339）岁孕周35~41周均（3752±493）周剖宫产手术指证：巨27例羊水19例胎妊娠双胎13例两组产妇年龄孕周等方面较统计学意义（P>005）具性
12方法
产妇均采子宫段横切口剖宫产术胎娩出组予卡前列素氨丁三醇注射液（生产厂家：Pharmacia & Upjohn company 1ml：250μg进口药物注册证号：H20120388）250 μg 宫体注射术2h注射次观察组组治疗基础联合卡贝缩宫素（辉凌制药限公司 支100μg：1ml 20150101）100μg：(1ml)静脉注射连续两天
13观察指标
记录产妇术224h出血量产出血发生率子宫收缩持续时间恶露持续时间FIB采免疫浊法Ddimer采ELISA法检测产出血量计算方法：出血量［胎娩出接血敷料湿重( g)－接血前敷料干重( g) 1 05( 血液重 gmL) 泌乳时间胎盘娩出乳房第次溢乳时间泌乳量评分：挤奶乳汁表现喷射状吸允乳房然没排空3分手法挤奶存奶乳汁溢出情况哺乳时间超8次d新生便超1次d便超5次d哺乳婴较安全乳房松软2分满足婴需添加代乳品1分没乳汁分泌0分
疗效标准参相关文献进行[10]：（1）子宫复旧良：产妇子宫收缩（2）子宫复旧良：产妇子宫收缩差
14统计学分析
研究数选择spss180进行统计较计量资料采t检验计数资料采χ2检验等级资料较秩检验P<005时表示差异显著
2结果
21两组产妇子宫复旧疗效较治疗观察组子宫复旧效率932明显高组子宫复旧效率746差异显著（P<005）见表1
表1 两组产妇子宫复旧疗效较[n()]
Table 1 Comparison of efficacy of two groups[n()]
Group
n
The uterus is well restored
Improved uterine healing
Uterine bad old
Efficient
Observation group
59
35（593）
20（339）
4（68）
932 a
Control group
59
29（492）
15（254）
15（254）
746
Note Compared with the control group a P＜005
22两组患者治疗前FIBDDimer检测值较：治疗前两组FIBDDimer检测值均较意义（P>005）治疗观察组FIBDDimer检测值均低组FIBDDimer检测值差异具较意义（P<005）见表2
表2 两组患者治疗前FIBDDimer检测值较（±s）
Table 2 Comparison of FIB DDimer between the two groups before and after treatment（±s）
Group
n
Time
FIB（gL）
DDimer（mgL）
Observation group
59
Before treatment
469±058
355±038
After treatment
347±045ab
122±025ab
Control group
59
Before treatment
466±050
354±037
After treatment
462±049b
346±035b
Note Compared with the control group aP＜005 Compared with Before treatment bP ＜005
23两组患者治疗前NONOS水较：治疗前两组NONOS水均较意义（P>005）治疗观察组NONOS水均低组NONOS水差异具较意义（P<005）见表3
表3 两组患者治疗前NONOS水较（±s）
Table 3 Comparison of NONOS levels between the two groups before and after treatment（±s）
Group
n
Time
NO（ μ m mo l L）
NOS（UmL）
Observation group
59
Before treatment
10524±1137
3832±471
After treatment
4132±527ab
1828±258ab
Control group
59
Before treatment
10333±1121
3767±477
After treatment
8819±938b
3156±401b
Note Compared with the control group aP＜005 Compared with Before treatment bP <005
24两组患者术出血情况较：观察组术2h出血量（23532±3519）术24h出血量（30134±3411）产出血率（51）宫缩持续时间（155±023）恶露持续时间（1533±287）均低组术2h出血量（36783±4089）术24h出血量（45319±4935）产出血率（186）宫缩持续时间（327±042）恶露持续时间（2119±312）差异具统计学意义（P<005）见表4
表4 两组患者术出血情况较（±s）
Table 4 Comparison of postoperative bleeding in both groups（±s）
Group
n
2 hours after surgery bleeding（ml）
24 hours after surgery bleeding（ml）
Postpartum hemorrhage rate n（）
Contractions lasted（h）
The duration of the lochia（d）
Observation group
59
23532±3519a
30134±3411a
3（51）a
155±023a
1533±287a
Control group
59
36783±4089
45319±4935
11（186）
327±042
2119±312
Note Compared with the control group aP＜005
25两组患者产泌乳时间泌乳量评分较：观察组泌乳时间（2038±318）低组泌乳时间（2708±353）观察组产1d泌乳量评分（157±026）产2d泌乳量评分（197±031）均高组产1d泌乳量评分（121±019）产2d泌乳量评分（153±025）差异具统计学意义（P<005）见表5
表5 两组患者产泌乳时间泌乳量评分较（±s）
Table 5 Comparison of postpartum lactation time and lactation score between the two groups（±s）
Group
n
Lactation time（h）
Postpartum 1d lactation score（Minute）
Postpartum 2d lactation score（Minute）
Observation group
59
2038±318a
157±026a
197±031a
Control group
59
2708±353
121±019
153±025
Note Compared with the control group aP＜005
3讨
产出血妇产科常见发症发病原较包括宫缩乏力凝血功障碍胎盘组织功异常等中宫缩乏力常见发病原[1112]引起宫缩乏力原产妇精神紧张体质虚弱子宫肌壁损伤患慢性疾病等剖宫产正常阴道分娩较剖宫产产妇般存巨胎妊娠前置胎盘等高危素加麻醉手术等影响产出血率显著提高剖宫产产妇新生造成严重威胁[13]预测剖宫产产出血史剖宫产手术程中重环节[14]
Ddimer交联纤维蛋白种降解产物反映纤维蛋白溶解功[15]机体血活化血栓形成纤维溶解活动Ddimer会升高[16]产出血具定预测作通Ddimer检测值变化判断剖宫产产出血危险素[17]FIB肝脏合成糖蛋白水升高时容易形成血栓[18]种种αAβBv链组成二聚体存吸附血浆中[19]具促进血板聚集滑肌生长皮细胞收缩增加血液粘滞性等作容易引起细胞损伤预防治疗剖宫产出血患者具重床意义通检测产妇FIB变化诊断出患者出血发生率[20]
NO种细胞毒性效应器种生物体许部分信号分子具较复杂生物学效应促进毛细血渗出[2122]NO具抑制宫缩作子宫滑肌活动密切相关NOS机体氧化合成限速酶活性NO水相关产妇子宫肌层胎盘组织等存NOS活性产妇妊娠中期检测NOS稳定表达宫缩乏力性产出血发生息息相关[23]通检测NONOS水变化观察产妇胎盘血流量子宫滑肌松弛度变化
泌乳种激素作已发育乳腺引起产妇通调节分泌系统促进乳腺中导系统生长发育生乳源泌乳通畅产妇感疼痛丘脑刺激催乳素抑制子降低泌乳素分泌抑制泌乳反射延迟泌乳减少泌乳量降低乳汁中蛋白质含量新生吸吮乳头刺激挤奶时工摩乳房刺激影响泌乳活动组织乳腺发育切断乳腺神[24]
卡前列素氨丁三醇称欣母沛前列腺2a种衍生物通提高肌细胞钙离子浓度形成诱发滑肌收缩机制达刺激子宫肌层协调力收缩作[25]效预防产妇产出血状况生物活性明显高传统前列腺素类药物剖宫产产妇该药促进子宫肌肉收缩胎盘处发挥止血效果旦注入宫体快速通血液循环发挥药效刻钟达高药物浓度[26]
卡贝缩宫素床防治产出血情况具[2728]：（1）起效快持续时间短需反复次药（2）子宫段收缩刺激作（3）子宫滑肌敏感性孕激素雄激素水密切相关等特点严重产出血卡贝缩宫素药效明显需加子宫收缩剂价钱传统缩宫素贵属常规药[2930]
研究显示单卡前列素氨丁三醇治疗剖宫产出血患者效率较低患者FIBDDimer检测值NONOS水变化明显[30]卡前列素氨丁三醇联合卡贝缩宫素产妇子宫复旧效率932明高单卡前列素氨丁三醇产妇子宫复旧效率746效果显著具较意义卡前列素氨丁三醇联合卡贝缩宫患者中FIBDDimer检测值NONOS水均低单卡前列素氨丁三醇患者联合药者术2h出血量术24h出血量产出血率均低单药者宫缩持续时间恶露持续时间均明显高单药者联合药者泌乳时间低单药者产1d泌乳量评分产2d泌乳量评分均显著升高见卡前列素氨丁三醇联合卡贝缩宫素治疗剖宫产出血患者效果显著具床意义
综述卡前列素氨丁三醇联合卡贝缩宫素剖宫产出血患者种预防方案够显著减少剖宫产产出血降低产出血发生率促进产恢复值床推广应
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