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目的:探讨卡前列素氨丁三醇预防剖宫产后出血的效果及对患者血浆D-二聚体和炎性因子水平的影响。方法:选择建德市妇幼保健院于2017年8月至2019年8月收治的剖宫产产后出血患者108例，依据随机数字表法分为观察组54例和对照组54例。两组患者均采用子宫下段横切口剖宫产术。对照组于胎儿娩出后给予缩宫素注射液；观察组在对照组基础上结合卡前列素氨丁三醇宫体注射。两组疗程为2 d。比较两组术后2 h和术后24 h出血量，恶露持续时间、子宫底下降速度和宫缩持续时间，治疗前后血浆D-二聚体和纤维蛋白原水平及肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)和白细胞介素8(IL-8)变化。结果:观察组术后2 h出血量(218.93±35.45)mL和术后24 h出血量(289.78±31.20)mL，均少于对照组的(328.18±49.27)mL和(432.15±43.87)mL(n t＝13.227、19.434，均n P<0.05)。观察组恶露持续时间(14.37±3.29)d，短于对照组的(20.93±5.46)d；子宫底下降速度(1.23±0.31)cm/d，快于对照组的(0.61±0.16)cm/d，而宫缩持续时间(3.26±0.72)d，长于对照组的(1.54±0.89)d；差异均有统计学意义(n t＝7.562、13.060、11.041，均n P<0.05)。观察组治疗后血浆D-二聚体(1.28±0.19)mg/L和纤维蛋白原水平(3.21±0.29)g/L，均低于对照组的(2.17±0.25)mg/L和(3.87±0.34)g/L(n t＝20.828、10.853，均n P<0.05)。观察组治疗后血清TNF-α(98.42±12.65)μg/L、CRP(23.14±3.28)mg/L和IL-8(41.38±10.10)ng/mL，均低于对照组的(183.25±19.28)μg/L、(31.89±4.35)mg/L和(65.27±18.29)ng/mL(n t＝27.033、11.802、8.402，均n P<0.05)。n 结论:卡前列素氨丁三醇辅助预防剖宫产产后出血患者效果良好，可减少产后出血，降低血浆D-二聚体水平，减轻炎性反应。“,”Objective:To investigate the effect of carboprost tromethamine on the prevention of postpartum hemorrhage after cesarean section and its influence on the plasma D-dimer level and inflammatory factors.Methods:From August 2017 to August 2019, 108 cases of postpartum hemorrhage after cesarean section admitted in the Maternal and Child Health Hospital of Jiande were divided into observation group (54 cases) and control group (54 cases) according the random digital table method.The patients in both two groups were treated by cesarean section.In the control group, oxytocin injection was given after delivery of the fetus.In the observation group, carboprost tromethamine was injected into the uterus on the basis of the control group.The course of treatment was 2 days.The amount of bleeding, duration of lochia, the rate of uterine fundus descent and duration of uterine contraction, the level of plasma D-dimer, fibrinogen and inflammatory factors before and after treatment were compared between the two groups.Results:The amount of bleeding in the observation group was (218.93±35.45)mL at 2h after operation and (289.78±31.20)mL at 24h after operation, which were less than those in the control group [(328.18±49.27)mL and (432.15±43.87)mL] (n t=13.227, 19.434, all n P<0.05). The duration of lochia in the observation group [(14.37±3.29)d] was shorter than that in the control group [(20.93±5.46)d], the rate of uterine fundus descending in the observation group[(1.23±0.31)cm/d] was faster than that in the control group [(0.61±0.16)cm/d], while the duration of uterine contraction in the observation group[(3.26±0.72)d] was longer than that in the control group [(1.54±0.89)d], the differences were statistically significant (n t=7.562, 13.060, 11.041, all n P<0.05). The levels of plasma D-dimer [(1.28±0.19)mg/L] and fibrinogen [(3.21±0.29)g/L] in the observation group were lower than those in the control group [(2.17±0.25)mg/L and (3.87±0.34)g/L] (n t=20.828, 10.853, all n P<0.05). The serum levels of TNF-α [(98.42±12.65)μg/L], CRP [(23.14±3.28)mg/L] and IL-8 [(41.38±10.10)ng/mL] in the observation group were lower than those in the control group [(183.25±19.28)μg/L, (31.89±4.35)mg/L and (65.27±18.29)ng/mL] (n t=27.033, 11.802, 8.402, all n P<0.05).n Conclusion:Carboprost tromethamine is effective in the prevention of postpartum hemorrhage after cesarean section.It can reduce postpartum hemorrhage, plasma D-dimer level and inflammation.