氨甲环酸联合卡贝缩宫素对预防凶险前置胎盘剖宫产术后出血的效果及对新生儿结局的影响  

The effect of combination of tranexamic acid and cabezine oxytocin on preventing bleeding after cesarean section for dangerous placenta previa and its impact on neonatal outcomes

作　　者：白雪英 Bai Xueying(Obstetrics and Gynecology Department of Xining First People's Hospital,Xining,Qinghai 810000,China)

机构地区：[1]西宁市第一人民医院,青海西宁810000

出　　处：《首都食品与医药》2024年第12期56-59,共4页Capital Food Medicine

摘　　要：目的观察氨甲环酸联合卡贝缩宫素对预防凶险前置胎盘剖宫产术后出血的效果及对新生儿结局的影响。方法选取西宁市第一人民医院产科2021年1月-2023年10月收治的98例凶险前置胎盘并行剖宫产患者,按照随机数字表法分为两组,每组各49例,对照组采用卡贝缩宫素治疗,研究组在对照组基础上联用氨甲环酸,比较两组方案的临床疗效。结果研究组止血总有效率和D二聚体(D-D)、纤维蛋白原(FIB)水平高于对照组,且新生儿不良结局发生率和活化部分凝血酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)低于对照组,术后2h与24h出血量少于对照组,恶露持续时间和止血时间短于对照组,宫缩持续时间长于对照组(P<0.05),同时研究组不良反应发生率高于对照组,但差异不显著(P>0.05)。结论氨甲环酸联合卡贝缩宫素预防凶险前置胎盘剖宫产术后出血能够有效提高凝血功能,减少术后出血量,改善患者和新生儿体征指标,治疗安全性和实用性较高。Objective To observe the effect of tranexamic acid combined with capecitabine on preventing bleeding after cesarean section for dangerous placenta previa and its impact on neonatal outcomes.Method 98 patients with dangerous placenta previa and concurrent cesarean section admitted to the Obstetrics and Gynecology Department of the First People's Hospital of Xining from January 2021 to October 2023 were selected.They were randomly divided into two groups,with 49 cases in each group.The control group was treated with cabezine oxytocin,while the study group was treated with tranexamic acid in combination with the control group.The clinical efficacy of the two groups was compared.Result The total effective rate of hemostasis and levels of D-dimer(D-D)and fibrinogen(FIB)in the study group were higher than those in the control group,and the incidence of adverse neonatal outcomes,activated partial thromboplastin time(APTT),thrombin time(TT),and prothrombin time(PT)were lower than those in the control group.The amount of bleeding was less than that in the control group at 2 and 24 hours after surgery,and the duration of lochia and hemostasis was shorter than that in the control group.The duration of uterine contractions was longer than that in the control group(P<0.05),the incidence of adverse reactions in the study group was higher than that in the control group(P>0.05).Conclusion The combination of tranexamic acid and cabezine oxytocin can effectively improve coagulation function,reduce postoperative bleeding,improve patient and neonatal signs,and have high safety and practicality in preventing postoperative bleeding in cesarean section with dangerous placenta previa.

关 键 词：氨甲环酸 卡贝缩宫素 凶险前置胎盘剖宫产 术后出血 新生儿结局 

分 类 号：R714.461[医药卫生—妇产科学]