宫腔水囊+纱条填塞对产后出血患者凝血功能、应激反应的影响  

Effect of uterine water bag+ gauze packing on coagulation function and stress response of patients with postpartum hemorrhage

作　　者：曾丽[1] ZENG Li(Department of Obstetrics,the Second People’s Hospital of Yibin City in Sichuan Province,Yibin City,Sichuan Province,644000,China)

机构地区：[1]四川省宜宾市第二人民医院产科,四川宜宾644000

出　　处：《海南医学院学报》2018年第13期1257-1260,共4页Journal of Hainan Medical University

基　　金：宜宾市科技计划项目(2014SF019)~~

摘　　要：目的:研究宫腔水囊+纱条填塞对产后出血患者凝血功能、应激反应的影响。方法:选择2014年6月~2017年5月在我院分娩并发生产后出血的患者作为研究对象,采用随机数表法分为接受宫腔水囊+纱条填塞止血的联合组、宫腔水囊止血的对照1组、纱条填塞止血的对照2组。观察整体临床疗效并在治疗前及治疗止血后,测定血清中凝血功能指标、应激反应指标的含量。结果:联合组患者的术中出血量、术后失血量、治疗前与治疗止血后血红蛋白的变化量均小于对照1组和对照2组;与组内治疗前比较,治疗止血后血清中APTT、PT的水平及FDP、ET-1、ANG-Ⅱ、ALD、NE、E、TNF-α、IL-6、ICAM1、VCAM1的含量均显著降低,PAI-1、AT-Ⅲ的含量均显著升高且联合组患者治疗止血后血清中APTT、PT的水平及FDP、ET-1、ANG-Ⅱ、ALD、NE、E、TNF-α、IL-6、ICAM1、VCAM1的含量均显著低于对照1组和对照2组,PAI-1、AT-Ⅲ的含量均显著高于对照1组和对照2组。结论:宫腔水囊+纱条填塞治疗产后出血能够较单一治疗手段取得更为理想的疗效并改善凝血功能、应激反应。Objective：To study the effect of uterine water bag ＋ gauze packing on coagulation function and stress response of patients with postpartum hemorrhage.Methods：Patients who gave birth and had postpartum hemorrhage in the hospital between June 2014 and May 2017 were chosen as the research subjects and divided into the combined group who received uterine water bag ＋ gauze packing hemostasis,the control group 1 who received uterine water bag hemostasis and the control group 2 who received gauze packing hemostasis.The overall clinical efficacy was observed,and the serum levels of blood coagulation function indexes and stress response indexes were determined before treatment and after treatment and hemostasis.Results：The intraoperative blood loss,postoperative blood loss and the change of hemoglobin before treatment and after treatment and hemostasis of combined group were less than those of control group 1 and control group 2;compared with those of same group before treatment,serum APTT and PT levels as well as FDP,ET-1,ANG-Ⅱ,ALD,NE,E,TNF-α,IL-6,ICAM1 and VCAM1 contents after treatment and hemostasis were significantly lower whereas PAI-1 and AT-Ⅲ contents were significantly higher,and serum APTT and PT levels as well as FDP,ET-1,ANG-Ⅱ,ALD,NE,E,TNF-α,IL-6,ICAM1 and VCAM1 contents of combined group after treatment and hemostasis were significantly lower than those of control group 1 and control group 2 whereas PAI-1 and AT-Ⅲ contents were significantly higher than those of control group 1 and control group 2.Conclusion：uterine water bag ＋ gauze packing treatment of postpartum hemorrhage can achieve better efficacy than monotherapy and improve the coagulation function and stress response.

关 键 词：产后出血 宫腔水囊 纱条填塞 凝血功能 应激反应 

分 类 号：R714.461[医药卫生—妇产科学]