氨甲环酸应用于凶险型前置胎盘剖宫产术中的有效性及安全性  

Efficacy and safety of tranexamic acid in reducing blood loss during cesarean section on the pernicious placenta previs

作　　者：罗钰[1] 杨堃[1] 陈华梅[1] 杨文燕[1] LUO Yu;YANG Kun;CHEN Huamei;YANG Wenyan(Department of Anesthesiology, The First Affiliated Hospital of Kunming Medical University, Kunming 650031, China)

机构地区：[1]昆明医科大学第一附属医院麻醉科,云南昆明650031

出　　处：《西部医学》2020年第11期1612-1615,共4页Medical Journal of West China

基　　金：国家自然科学基金(81560320,81760348);云南省高层次卫生技术人才培养项目(H-201647)。

摘　　要：目的探讨在凶险型前置胎盘剖宫产术中应用氨甲环酸对术中失血量、术后凝血功能的影响并对其安全性进行评价。方法选择2017年11月~2018年3月我院确诊为凶险型前置胎盘的患者60例,根据简单随机抽样法,将患者分为试验组和对照组,每组各30例。两组患者术前取中心静脉血3~5 mL行Sonoclot凝血及血小板功能分析(SCA)。试验组在胎儿分娩后即刻使用氨甲环酸氯化钠注射液200 mL静脉滴注,对照组在相同时刻使用0.9%氯化钠注射液200 mL静脉滴注。术毕再次行Sonoclot测定分析,并观察术中失血量、输血量,术后24小时随访患者有无并发症。结果试验组凝血速率(CR)高于对照组;试验组血小板功能(PF)高于对照组(P<0.05)。试验组失血量、输血量、悬浮红细胞输注量均低于对照组(均P<0.05)。结论在凶险型前置胎盘患者术中使用氨甲环酸可以改善患者围术期凝血功能,减少失血量和悬浮红细胞输注量及输血相关并发症的发生率,安全性好。Objective To investigate the effect of tranexamic acid on intraoperative blood loss,postoperative coagulation function and its safety in dangerous placental cesarean section.Methods 60 patients with pernicious placenta previa from November 2017 to March 2018 were selected and divided into experimental group and control group according to simple random sampling method,with 30 cases in each group.Before operation,3-5 ml of central venous blood was collected for Sonoclot coagulation and platelet function analyzer(SCA).The experimental group was given tranexamic acid sodium chloride injection 200 ml intravenous drip immediately after delivery,and the control group was given 200 ml intravenous drip of 0.9%sodium chloride injection at the same time.At the end of the operation,Sonoclot was measured and analyzed again.The blood loss and blood transfusion volume were observed.The patients were followed up for 24 hours to see if there were any complications.Results The coagulation rate(CR)of the experimental group was higher than that of the control group,and the platelet function(PF)of the experimental group was higher than that of the control group(P<0.05).The blood loss,blood transfusion and suspended red blood cell transfusion in the experimental group were lower than those in the control group(P<0.05).Conclusion Patients with placenta previa in disaster intraoperative use of tranexamic acid can improve patients perioperative blood coagulation function,decrease blood loss and suspended red blood cells infusion,and does not increase the incidence of adverse reactions such as thrombosis.

关 键 词：凶险型前置胎盘 氨甲环酸 剖宫产术 SONOCLOT 

分 类 号：R719.8[医药卫生—妇产科学]