血凝酶联合麦角新碱治疗产后出血疗效及对患者纤溶、凝血功能、应激状态的影响  

Therapeutic effect of hemocoagulase combined with ergonovine in treatment of postpartum hemorrhage and its influence on fibrinolysis,coagulation function and stress state of patients

作　　者：骈晓琴 穆晓洁 刘维佳 赵晓峰[1] PIAN Xiaoqin;MU Xiaojie;LIU Weijia;ZHAO Xiaofeng(Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院,内蒙古呼和浩特010050

出　　处：《陕西医学杂志》2023年第11期1583-1587,共5页Shaanxi Medical Journal

基　　金：内蒙古自治区自然科学基金资助项目(2019MS08150)。

摘　　要：目的:探讨血凝酶联合麦角新碱治疗产后出血疗效及对患者纤溶、凝血功能及应激状态的影响。方法:选取106例产后出血患者,随机分为两组,每组53例。对照组采用麦角新碱治疗,观察组采用注射用血凝酶联合麦角新碱治疗。比较两组临床疗效及纤溶功能指标[血小板(PLT)、血红蛋白(HGB)]、凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、D-D二聚体(D-D)及纤维蛋白原(Fib)]、血流动力学指标[子宫动脉收缩期峰值流速(PSV)、搏动指数(PI)、心率(HR)]、应激状态指标[一氧化氮(NO)、一氧化氮合酶(NOS)]。结果:治疗前两组纤溶功能指标比较无统计学差异(均P>0.05),治疗后观察组PLT、HGB水平高于对照组(均P<0.05)。治疗前两组凝血功能指标比较无统计学差异(均P>0.05),治疗后观察组TT、PT、APTT、D-D、Fib水平低于对照组(均P<0.05)。治疗前血流动力学指标组间比较无统计学差异(均P>0.05),治疗后观察组的整体血流动力学指标包括PSV、PI优于对照组(均P<0.05),HR差异无统计学意义(P>0.05)。治疗前两组应激状态指标比较无统计学差异(均P>0.05),治疗后观察组B型脑利钠肽(BNP)、NO、NOS水平低于对照组(均P<0.05)。治疗后观察组宫缩、恶露持续时间均比对照组短,子宫底下降速度比对照组快(均P<0.05)。观察组治疗后3、5 d的宫底下降高度均比对照组低(均P<0.05)。观察组不良反应发生率低于对照组(P<0.05),观察组临床疗效高于对照组(P<0.05)。结论:产后出血患者采用注射用血凝酶配合麦角新碱治疗止血效果明显,患者凝血功能明显改善,其纤溶功能指标和应激状态指标均趋于正常水平,血流动力学得到改善。Objective:To explore the therapeutic effect of hemocoagulase combined with ergonovine in treatment of postpartum hemorrhage and its influence on fibrinolysis,coagulation function and stress state of patients.Methods:106 patients with postpartum hemorrhage were randomly divided into two groups,with 53 cases in each group.The control group was treated with ergometrine,while the observation group was treated with injectable hemagglutinin combined with ergometrine.Compare two groups of clinical efficacy and fibrinolytic function indicators(platelet[PLT],hemoglobin[HGB]),coagulation function indicators(prothrombin time[PT],thrombin time[TT],activated partial thromboplastin time[APTT],D-D dimer[D-D],and fibrinogen[FIB]),hemodynamic indicators(peak systolic velocity[PSV],Pulsatile Index[PI],heart rate[HR]of uterine artery),and stress state indicators(nitric oxide[NO],nitric oxide synthase[NOS]).Results:There were no significant differences in fibrinolytic function indexes between the two groups before treatment(all P>0.05).After treatment,the PLT and HGB levels in the observation group were higher than those in the control group(all P<0.05).There were no statistically significant differences in coagulation function indexes between the two groups before treatment(all P>0.05).After treatment,the levels of TT,PT,APTT,D-D and Fib in the observation group were lower than those in the control group(all P<0.05).There were no significant differences in hemodynamic indexes between the two groups before treatment(all P>0.05).After treatment,the overall hemodynamic indexes including PSV and PI in the observation group were better than those in the control group(all P<0.05),but there was no significant difference in HR between the two groups(P>0.05).There were no statistically significant differences in stress state indexes between the two groups before treatment(all P>0.05).After treatment,the levels of B-type natriuretic peptide(BNP),NO and NOS in the observation group were lower than those in the control group(all P<0.05).After

关 键 词：产后出血 血凝酶 麦角新碱 应激状态 凝血功能 出血量 

分 类 号：R714.461[医药卫生—妇产科学]