前置胎盘剖宫产产后出血麦角新碱联合手术止血效果及对血D-二聚体影响  

Effect of ergostine combined with hemostasis operation for treating women with postpartum hemorrhage after cesarean section caused by placenta previa and its influence on the D dimer level

作　　者：罗静[1] 姚阳 陈文忠[1] 宋凯 LUO Jing;YAO Ming;CHEN Wenzhong;SONG Kai(Kunming First People's Hospital,Kunming,Yunnan Province,650000)

机构地区：[1]云南省昆明市第一人民医院,650000

出　　处：《中国计划生育学杂志》2023年第10期2421-2425,共5页Chinese Journal of Family Planning

基　　金：昆明市卫生健康委员会卫生科研课题项目(2021-05-02-006)。

摘　　要：目的:探讨麦角新碱联合止血手术对前置胎盘剖宫产产后出血患者止血效果及D-二聚体(D-D)的影响。方法:回顾性分析本院2019年1月-2022年1月收治的前置胎盘剖宫产产后出血患者120例临床资料,均采用子宫动脉栓塞术或宫腔球囊压迫止血术治疗,术后麦角新碱辅助治疗为联合组(n=76)、非麦角素治疗对照组(n=44)。比较两组临床指标、止血效果、应激状态、凝血功能指标,随访3个月不良反应情况。结果:联合组止血有效率(96.1%)高于对照组(84.1%),恶露持续时间(16.0±2.1d)、产后2 h内出血量(1240.4±110.2ml)、产后2~24h出血量(513.9±52.2 ml)、住院时间(7.5±1.4d)均低于对照组(26.5±3.5d、1610.3±150.8 ml、745.2±40.7 ml、10.9±2.7d);治疗后两组血清皮质醇、去甲肾上腺素、肾上腺素水平均降低且联合组低于对照组,两组凝血酶原时间、凝血活酶时间、纤维蛋白原、D-D水平均降低且联合组低于对照组;不良反应发生率联合组(5.3%)低于对照组(18.2%)(均P<0.05)。结论:麦角新碱联合止血手术治疗前置胎盘剖宫产产后出血止血效果提高,可有效改善产妇临床指标和凝血功能,降低D-D水平,控制应激状态,且安全性高。Objective:To explore the effect of ergostine combined with hemostasis operation for treating women with postpartum hemorrhage after cesarean section caused by placenta previa,and to study its influence on the D dimer(D-D) level of the women.Methods:The clinical data of 120 women with postpartum hemorrhage after cesarean section caused by placenta previa from January 2019 to January 2022 were analyzed retrospectively.All these women were treated with uterine artery embolization or uterine balloon compression hemostasis and were divided into two groups according to ergostine used or not.44 women in the control group were not given ergostine,and 76 women in the observation group were given ergostine.The clinical indicators,the hemostatic effect,the stress state,and the coagulation function indicators of the women were compared between the two groups.The adverse reactions within 3 months after treatment of the women in the two groups were followed up.Results:The effective rate of hemostasis(96.1%) of the women in the observation group was significantly higher than that(84.1%) of the women in the control group.The lochia duration(16.0±2.1d),the blood loss in postpartum 2h(1240.4±110.2ml) and from postpartum 2 h to 24(513.9±52.2 ml),and the hospital stay(7.5±1.4d) of the women in the observation group were significantly lower than those(26.5±3.5d,1610.3±150.8ml,745.2±40.7ml,and 10.9±2.7d) of the women in the control group.The levels of serum cortisol,norepinephrine,epinephrine,fibrinogen,and D-D,and the values of prothrombin time and thrombin time of the women in both groups after treatment had decreased significantly,and which of the women in the observation group were significantly lower than those of the women in the control group.The incidence of adverse reactions(5.3%)of the women in the observation group was significantly lower than that(18.2%)of the women in the control group(all P<0.05).Conclusion:Ergotine combined with hemostasis operation for treating women with postpartum hemorrhage after cesarean se

关 键 词：前置胎盘 剖宫产产后出血 球囊压迫止血术 子宫动脉栓塞术 角新碱 止血效果 D-二聚体 

分 类 号：R714.461[医药卫生—妇产科学]